Authorities alarmed as haemophilia patients found infected with hepatitis, HIV

The Communicable Disease Control (CDC) Sindh has asked the Sindh Blood Transfusion Authority (SBTA) to immediately inquire into how several haemophilia patients in Karachi received infected blood products, due to which several of them got infected with hepatitis B and C, as well as HIV.

“As you are well aware of the shocking fact that 97 out of 250 people with haemophilia tested positive for various infectious diseases including 91 for hepatitis C, two for hepatitis B and four for HIV at a free screening camp jointly organised by the CDC (HIV/AIDS) in collaboration with Sindh Blood Transfusion Authority and Hemophilia Welfare Society,” wrote Dr Irshad Kazmi, CDC (HIV/AIDS) Sindh additional director, in a letter to the SBTA on Saturday.

The CDC initially claimed that 170 of the 250 haemophilia patients recently screened by the provincial health authorities in Karachi were found to be infected with hepatitis C, Hepatitis B, HIV or other blood-borne diseases following a screening camp but after confirmatory tests, it emerged that 97 of them were found to be infected with these viral diseases.

In his letter to the SBTA director, Dr Kazmi said it was obvious that no lessons had been learnt from the earlier HIV outbreak of 2019 in Larkana by the blood transfusion authority and Sindh Health Care Commission.

“Quacks and substandard blood banks are back in business throughout the province, including Ratodero, while indiscriminate use of cheap, manual, unapproved and substandard screening kits by the substandard blood banks has also been going on unchecked,” Dr Kazmi maintained.

He said the CDC worked to control infectious diseases that posed a threat to the public health. He added that the CDC HIV directorate recommended an inquiry into how and where those haemophilia patients received infected blood products. “Those responsible for putting the lives of innocent people in grave danger must be held accountable,” Dr Kazmi wrote. He lamented that any lethal consequences of unsafe blood transfusion were avoidable.

The CDC official said it was the job of the SBTA, which was a government body, to ensure provision of safe blood products to all those who needed them. He added that the authority must not ignore this wake-up call. “The findings of the inquiry may kindly be shared with the CDC (HIV/AIDS), Directorate General Health Services Sindh,” the letter read.

According to experts, haemophilia is a rare and serious X-chromosome-linked congenital bleeding disorder that affects the blood's ability to clot, meaning that people with haemophilia bleed for a longer time than normal. It is estimated that about 1 in 10,000 people are affected by haemophilia, with 450,000 people living with the disease worldwide. It is estimated that around 24,000 people are living with haemophilia in Pakistan.

According to Raheel Ahmed, the chief executive officer of the Haemophilia Welfare Society Karachi, as state-of-the-art treatment of haemophilia is not available in Pakistan, its treatment is carried out through blood by-products where plasma of healthy patients is given to haemophilia patients. Earlier talking to The News, he said that this method of treatment had become obsolete in the developed countries. "As blood screening standards are very poor in the country, often plasma of people infected with viral hepatitis and HIV is transfused to haemophilia patients, which makes the lives of these patients more hard and miserable,” he said and added that viral infections acquired through infected blood were the leading cause of deaths among the haemophilia patients.

Ahmed, who is himself a haemophilia patient, claimed that the treatment of haemophilia through injectable factor XIII and other factors that were given regularly to patients, cost around three hundred thousand rupees in Pakistan. He said that most of the time, factors or injections for haemophilia treatment were not available in the country.

"There are around 24,000 haemophilia patients in Pakistan, of whom approximately 9,400 are in Sindh alone. There are around 900 haemophilia patients registered with us, who need treatment with factor XIII and other factors,” he said as he urged the Drug Regulatory Authority of Pakistan and other authorities to make the modern treatment of haemophilia available in the country.

The World Federation of Hemophilia (WFH) reported that 195,263 patients from 115 countries were diagnosed with haemophilia in 2019, of whom 2,233 belonged to Pakistan. The actual number of people suffering from the disease, however, remains unknown and could be very high due to the high level of consanguinity, scarcity of funds for diagnostic facilities and poor awareness about the disease.