02 September 2010
By Pritha Chatterjee
Mumbai, India
HIV tests using ELISA kits, with third–generation technology, sent to all blood banks in the state are giving wrong results, blood bank officials say.
Experts are now considering the more accurate Nucleic Acid Test (NAT). The Mumbai District AIDS Control Society (MDACS) is already in the process of trying to incorporate NAT.
"The kits are problematic. After we got contradictory results in the same patients in consecutive tests, we started testing samples at least 3–4 times before declaring HIV results," said an MDACS officer at the government–run St George Hospital. "We have had to change reports of 5–6 patients in August," said an RMO from the hospital.
Dr Yogini Patel, who is in charge of blood transfusion, Mumbai District AIDS Control Society, said, "In about two months, we received 20 25 reports of inconsistency in tests using these new kits. We will review the technology before sending the next batch."
She added MDACS was raising the matter of incorporating NAT in blood banks. "The Delhi Government has mobilised resources and is in the process of making NAT compulsory in all hospitals.
There are lacunae with ELISA, and we want to shift to a better and stronger test in Mumbai...," she said.. Dr Debashish Gupta, who is in charge of blood transfusion, NACO, while admitting reports of faulty tests, said, "There are limitations in the method. But problems could also occur because of faulty storage, transportation or mishandling of kits. We are looking into the problem."
No Government hospital in Maharashtra provides NAT. PD Hinduja Hospital in Mahim is the sole blood bank in the state that has NAT equipment. ELISA test has a three–month window period, the time the virus is multiplying in a donor's body but does not show itself, due to limitations in testing technology.
This is true for Hepatitis B, C and HIV. NAT has been adopted at the All India Institute of Medical Sciences (AIIMS) and Ram Manohar Lohia Hospital, Delhi.
Dr Gupta said, "NAT is a sound test. But it requires trained manpower, equipped labs and added cost of consumables. Maharashtra hospitals, in meetings, admitted they are short of manpower and are not ready for such an upgrade."
Experts said cost is a limiting factor. "Every NAT test will cost between Rs 2,000–5,000. Considering that is not feasible for the State Government settings at the moment, we are focussing on counselling and procuring honest behavioural and life style related history from donors," said Dr Yogini Patel.
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