Five years of safe blood at SANBS

The South African National Blood Service
has diminished the risk of transferring
viruses through its blood supply.
(Images: Nosimilo Ramela)

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Bongani Nkosi

Blood safety standards at the South African National Blood Service (SANBS) have been at their best over the last five years, the organisation announced on 25 July 2011.

The non-profit body said new data shows it has significantly diminished the risk of transferring viruses such as HIV, and hepatitis B and C through its blood supply.

This is largely thanks to the use of the Novartis nucleic acid testing (NAT) system introduced in 2005, which screens donated blood for HIV and strains of hepatitis.

The data is an incredible public health story, SANBS said.

“Since we started performing IDT-NAT (individual donor testing-NAT), we have virtually eliminated the risk, with no reports of HIV-1 infections from transfused blood or blood products,” said its chief operations officer Ravi Reddy.

“This represents a significant increase in patient safety in South Africa, and I hope this serves as a model for other countries,” he added.

According to Reddy, transmission of HIV and hepatitis infections from donated blood used to be more prevalent in South Africa before the introduction of NAT.

SANBS has screened at least 3.8-million blood donations for the viruses through NAT since 2005.

The organisation collects an average of 780 000 units of blood annually from voluntary donations and is a major supplier of “vein to vein” blood transfusion services in the country. It has 79 blood banks serving over 1 000 hospitals and clinics in eight of the nine South African provinces.

The Western Cape is covered by the Western Province Blood Transfusion Service, which has also been using NAT since 2005.

NAT more effective than serology

NAT has proven to be more effective than the serology test, as it is highly sensitive to the genetic material of the virus, SANBS said. It can detect active infections that traditional serology testing can miss, according to the organisation.

SANBS has been able to detect 6 487 HIV-positive units of donated blood due to the use of NAT – 96 of these units would not have been identified by serology testing.

There were 3 007 Hepatitis B-positive units found, of which 346 went undetected with serology testing alone, it said.

At least 250 Hepatitis C-positive units were identified, of which five were undetected by serology testing.

“These units of infected blood would have tested negative and been made available for transfusion to patients if not removed from the blood supply following NAT testing,” the organisation said.

SANBS has not eradicated serology testing altogether, as it still uses the system on all samples in addition to NAT testing.

Given that there are over 5-million people living with HIV in South Africa, SANBS is clear of the risk of HIV-infected blood entering the national blood supply.

It noted that according to the World Health Organisation, between 5% and 10% of all HIV infections worldwide have been acquired through transfusions of infected blood and blood products.

Some blood donors may not be aware of being infected by the transmittable viruses. “This makes it essential that our blood-screening programmes employ a testing method that will help us deliver the safest possible blood,” said Reddy.

“The data shows that NAT in IDT has achieved that result (delivering safe blood) in South Africa,” he added.