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Transfusion of blood safer from HIV than ever
Louise Flanagan, IOL
2008-07-16
No blood transfusions have been linked to HIV infections since more sophisticated testing started more than two years ago, says the South African National Blood Service.
We are safer than we have
ever been, says SANBS medical director Dr Sam Gulube. He says nucleic acid
amplification testing (NAT) has been used since October 2005, and since then, no
HIV transmission has been linked to a blood transfusion. Before that there
were two a year every year from 2000 to 2005. Gulube says the NAT tests
definitely cut this transmission risk and significantly reduced the
window period during which the virus cannot be detected, but did not eliminate
it entirely. The SANBS tests every single unit of blood - about 3 000 units of
blood a day, at a cost of about R115 each. That's about R344 000 a day on the
NAT tests alone. Blood is also tested for hepatitis B and C, and syphilis.
South Africa is the first country in the world to have implemented
individual NAT testing on such a large scale, taking the lead from First World
countries such as the US and UK, says Gulube.
On Monday it was reported that a
young boy had been at risk of HIV infection after a transfusion during an
operation at
St Augustine
's hospital in
Durban
, but both Gulube and the hospital said the child had not been given
contaminated blood.
St Augustine
's general manager Augusta Dorning said the hospital received a letter from the
SANBS on March 25, warning that the blood donor could have been in the window
period for possible infection at the time the donation was given to the child.
The child, the son of a hospital employee, was thus tested as a precaution and
found to be HIV-negative. Dorning dismissed unconfirmed reports of another case.
Gulube said the child was checked as part of the SANBS's look back
programme, which tracks earlier recipients if a donor is found to be
HIV-positive during a later donation. This is in case the previous donation was
made during the window period.
Gulube said this was a sensitive
issue, but a necessary safety precaution. We get about 80 to 100 donors
becoming HIV positive a year, out of 350 000, he said - which is 0,028
percent of donors. All the recipients of their last donation are then contacted
for a follow-up. Gulube said the checking worked both ways, so if the recipient
of a blood transfusion later tested positive for HIV, the donor would be
contacted for testing. If a patient who has received blood before becomes
HIV-positive, the first agent you are going to blame is the blood. He said
there were about 30 such cases every three months. Usually, our donors
understand this and are gracious. Gulube said about 2% of donated blood
was discarded each year. He said most donors were honest about their status and
risk profile. Almost 100 percent of those who donate do it because they
want to help somebody.
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