Fri, 12 Jul 2002

HIV infection via transfusions on the rise

Debbie A. Lubis and Muninggar Sri Saraswati, The Jakarta Post, Jakarta

Most people still think that the spread of HIV/AIDS here is mainly caused by the sharing of syringes -- usually between drug users -- and unsafe sex. However, one may also be infected by HIV/AIDS via a blood transfusion.

The World Health Organization (WHO) estimates that 5 percent to 10 percent of people with AIDS are infected via blood transfusions.

In Indonesia, the prevalence of HIV among the recipients of blood donations sharply increased, from 0.002 percent in 1992 to 0.15 percent in 2000, according to the Ministry of Health.

Official data shows that there are 120,000 people living with HIV/AIDS in the country.

The Indonesian Red Cross (PMI), as well as most hospitals here, carries out an initial screening to check the blood for possible HIV/AIDS using a specific test to detect the virus antibodies, known as the Elisa test.

Chairman of the Blood Transfusion Unit at PMI Sujudi and AIDS expert to Cipto Mangunkusumo General Hospital (RSCM) Dr Noroyono Wibowo admitted, however, that the Elisa test could not guarantee that the blood that had passed was HIV/AIDS-free.

Sujudi explained how the Elisa test might fail to recognize possible HIV/AIDS antibodies.

"Failure is possible due to low-quality liquid reagents used in the test or due to human error," he told The Jakarta Post in his office.

Personal adviser to the chief executive officer of Siloam Gleneagles hospital in Karawaci, Tangerang, Eva Fifenly told the Post that the hospital always checked its blood intended for transfusion. It also double-checked the blood taken from the Indonesia Red Cross (PMI).

"We always check the blood here using a method known as the rapid test," she said.

This is similar to the Elisa test. Should the test reveal the possibility of HIV/AIDS, at the patient's request the hospital will screen the blood using the Western Blot test.

That and the Polymerized Chain Reaction are two tests that can confirm the presence or absence of HIV/AIDS.

The management of Pondok Indah hospital and the Metropolitan Medical Center, both in South Jakarta, refused to make any comment.

However, a doctor at Pondok Indah and a member of staff at MMC separately told the Post that the hospitals deployed a similar procedure to test blood.

"That's an international standard observed by most hospitals in the world," the doctor, who wished to remain anonymous, said on Thursday.

While the Elisa test costs only Rp 47,000 (US$5.20), the Western Blot costs Rp 522,000 per test and the Polymerized Chain Reaction is Rp 1,250,000.

The price of a 250 cc pouch of blood from PMI for private hospitals is Rp 130,000 while that for state hospitals is Rp 65,000. The price includes the cost of screening.

A man who was recently hospitalized at Pondok Indah regretted that he had not been informed about the test in the first place.

"I wouldn't mind paying a considerable sum to avoid the risk of getting infected with HIV," he said.

Since 1992, PMI has been screening donated blood for possible HIV/AIDS using the Elisa test.

Last year the Elisa test enabled PMI to discover that about 100 of a total 1.2 million pouches of blood here contained possible HIV/AIDS.

"Should the test indicate that the sample is HIV-positive, we will send it to be rechecked using the Western Blot test at the Ministry of Health or to RSCM for the Polymerized Chain Reaction as we can't afford the equipment necessary for the tests," Sujudi said.