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Nucleic Acid Amplification Testing

Nucleic Acid Amplification Testing:

The Supreme Court of India has sought comprehensive details regarding the cost, feasibility, and infrastructure required to implement Nucleic Acid Amplification Testing (NAT) in government hospitals, responding to a Public Interest Litigation (PIL) that advocates for the prevention of transfusion-transmitted infections.

  • The PIL, urges the Court to declare the “Right to Safe Blood” as an intrinsic facet of the Right to Life under Article 21 of the Indian Constitution.
  • The petition seeks directions to make NAT mandatory across all Indian blood banks.
  • This aims to accurately detect Transfusion Transmissible Infections (TTIs), including HIV, Hepatitis B (HBV), Hepatitis C (HCV), malaria, and syphilis, before the blood is transfused.
  • Currently, under the Drugs and Cosmetics Act of 1940, mandatory blood screening in India only requires serological testing (such as Enzyme-Linked Immunosorbent Assays).
  • Nucleic Acid Testing is not legally mandatory across the country.
  • The plea highlights the systemic failure to protect highly vulnerable patients, noting that India is considered the “Thalassemia capital of the world.”
  • Thalassemia is an inherited (genetic) blood disorder characterized by the body’s inability to produce sufficient haemoglobin (the protein in red blood cells that carries oxygen).
  • Thalassemia patients require life-saving blood transfusions every 15 to 20 days, making them highly susceptible to TTIs if blood is improperly screened.
  • The petition highlighted preventable cases in Madhya Pradesh, Jharkhand, and Uttar Pradesh where children contracted HIV and Hepatitis due to unsafe blood transfusions.

Nucleic Acid Amplification Testing (NAT):

  • It is a highly sensitive molecular technique that screens blood donations by amplifying targeted regions of viral Ribonucleic Acid or Deoxyribonucleic Acid.
  • Traditional serological tests must wait for the human body to produce an immune response (antibodies) before an infection can be detected.
  • Nucleic Acid Testing directly detects the virus, drastically narrowing the “window period” (the time between initial infection and detectability) for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus.
  • This advanced testing helps identify “false reactive” blood donations that standard serology methods incorrectly flag as infected.
  • This ensures safe blood is not unnecessarily discarded and aids in accurate donor counselling.