Hepatitis C virus infection in a Brazilian population with sickle-cell anemia

Abstract

Patients with sickle-cell anemia submitted to frequent blood transfusions are at risk of contamination with hepatitis C virus (HCV). Determination of HCV RNA and genotype characterization are parameters that are relevant for the treatment of the viral infection. The objective of the present study was to determine the frequency of HCV infection and the positivity for HCV RNA and to identify the HCV genotype in patients with sickle-cell anemia with a history of blood transfusion who had been treated at the Hospital of the HEMOPE Foundation. Sera from 291 patients were tested for anti-HCV antibodies by ELISA 3.0 and RIBA 3.0 Chiron and for the presence of HCV RNA by RT-PCR. HCV genotyping was performed in 19 serum samples. Forty-one of 291 patients (14.1%) were anti-HCV positive by ELISA and RIBA. Both univariate and multivariate analysis showed a greater risk of anti-HCV positivity in those who had started a transfusion regime before 1992 and received more than 10 units of blood. Thirty-four of the anti-HCV-positive patients (34/41, 82.9%) were also HCV RNA positive. Univariate analysis, used to compare HCV RNA-negative and -positive patients, did not indicate a higher risk of HCV RNA positivity for any of the variables evaluated. The genotypes identified were 1b (63%), 1a (21%) and 3a (16%). A high prevalence of HCV infection was observed in our patients with sicklecell anemia (14.1%) compared to the population in general (3%). In the literature, the frequency of HCV infection in sickle-cell anemia ranges from 2 to 30%. The serological screening for anti-HCV at blood banks after 1992 has contributed to a better control of the dissemination of HCV infection. Because of the predominance of genotype 1, these patients belong to a group requiring special treatment, with a probable indication of new therapeutic options against HCV.

Hepatitis B and C Infections and Different Genotypes of HCV Among Sickle Cell Anemia Patients in Ahvaz, South-Western Iran

“…This rate is higher than that of the blood donors in the region. Furthermore, the anti-HCV prevalence in the current study (12.5%) was lower than that ofthe multi-transfused patients in some neighbouring Arabic countries (29.4 to 44%) (23)(24)(25) and other countries such as Pakistan (48.6%) (26) and Brazil (14.1%) (13).…”

“…Recent studies of SCA patients show that the prevalence of anti-HCV varied (4.5 to 21%) (2,(11)(12)(13), which suggests that the geographical area may affect the potential risk of HCV in patients (17)(18)(19). Moreover, one of the most common causes of HCV transmission by transfusion is the occurrence of new infections in blood donors.…”

Anemia falciforme e infecções

“…These patients present the risk of acquiring the infection by hepatitis C virus from the blood transfusions to which they are submitted, 1,29 especially those who received blood transfusions before serum screening for anti-HCV antibodies in blood banks was started. A study performed in Pernambuco also showed an increased prevalence of infection by HCV among those individuals who had received more than 10 units of blood-based products.…”

“…A study performed in Pernambuco also showed an increased prevalence of infection by HCV among those individuals who had received more than 10 units of blood-based products. 29 The prevalence of hepatitis C virus infection varies from 2 to 30% in individuals with sickle-cell anemia, when in the overall population it is estimated at 3%. 29 …”

“…29 The prevalence of hepatitis C virus infection varies from 2 to 30% in individuals with sickle-cell anemia, when in the overall population it is estimated at 3%. 29 …”