While National Aids control Organisation (NACO) programme conducts active screening and treatment of HIV infection, making considerable dent in new cases, hepatitis has no active screening campaign under central or state government.
Even as new detections of HIV positive cases have steadily declined over years, Hepatitis continues to show a large pool among voluntary blood donors in Maharashtra, indicating a need to tap the hidden infected population. In 2016, of 16.17 lakhs unit of blood collected in state through blood donation drives and camps, 16,554 units were found infected with Hepatitis B virus and 4,458 units with Hepatitis C virus. Detection of HIV was much lower at 3,070 units, 141 units were malaria positive and 834 blood units were syphilis positive.
While National Aids control Organisation (NACO) programme conducts active screening and treatment of HIV infection, making considerable dent in new cases, hepatitis has no active screening campaign under central or state government. “We only conduct immunisation drive for children. The hepatitis vaccine has high efficacy ensuring the coming generations do not contract the viral infection,” said Dr Satish Pawar, director, Directorate of Health Services (DHS).
Data accessed by The Indian Express from State Blood Transfusion Council (SBTC) showed that Osmanabad holds the largest burden of Hepatitis B where 1.98 per cent of 4,895 blood donors in 2016 were found positive.
The detection of HIV virus remained less than 0.3 per cent across Maharashtra in contrast to 1.2 per cent average detection of Hepatitis B virus.
After Osmanabad, Solapur, Nanded, and Wardha showed high detection of hepatitis amongst blood donors in comparison to other states with 1.4 per cent testing positive for the viral infection on average.
“Hepatitis population still remains hidden. Most do not know they have the infection,” said Dr Arun Thorat, in-charge of SBTC. According to Henk Bekedem, World Health Organisation representative to India, most living with hepatitis do not know about the infection until they suffer from liver cirrhosis.
“It’s a silent disease. We need awareness and focused screening to diagnose new patients,” he said.
SBTC data showed that while blood donation escalated from 15.6 lakhs units in 2015 to 16.17 lakhs in 2016, the government had to do away with at least 50,799 blood units in two years due to HIV, hepatitis, malaria, or syphilis detection.
A NACO guideline states that all counselors at blood camps must take history of donors to assess if they are at risk of infection.
In case a blood sample tests positive for any virus, the donor must be contacted and counselled. State officials, however, admit that contact tracing hardly happens.
“We are now starting training of counsellors to take complete history of donors. Each counsellor will have to inform donor if their blood is found infected, and counsel their spouse,” said Dr Shrikala Acharya, additional project director at Mumbai District Aids Control Society.
Mumbai topped in blood donation drive through 2,906 camps held last year, collecting three lakh blood units. Of this, 802 donors were later found to have HIV infection, 4,686 had Hepatitis B or C, and 392 had syphilis.
According to liver specialist Abha Nagral, hepatitis can spread through body fluids, injectables, dental work, tattooing, blood transfusion and unprotected sexual contact.
It is 42 times more infectious than HIV virus as it remains alive even in dried blood for seven days. India is estimated to have 40 million Hepatitis B infected population and six million people with Hepatitis C.
Author: Tabassum Barnagarwala