Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus Infection in Multi-Transfused Thalassemic Patients, Kermanshah, Iran, 2015

Abstract

Background: Repeated blood transfusions in Thalassemic patients predispose them to blood-borne infections including Hepatitis B, Hepatitis C, and human immunodeficiency virus. These infections cause cirrhosis, portal hypertension, and acquired immunodeficiency syndrome. Objectives: The current study aimed at determining the prevalence of these infections in Thalassemic patients of Kermanshah province, Iran. Methods: Thalassemic patients registered at Mohammad Kermanshahi university hospital were included. Demographic data, history of blood transfusions, Hepatitis B surface antigen (HBsAg), Hepatitis B core antibody (HBC Ab), Hepatitis B surface antibody (HBs Ab), Hepatitis C antibody, and Human immunodeficiency virus (HIV) antibody were extracted. Serologic tests were done using the third-generation enzyme linked immunosorbent assay (ELISA) and positive Hepatitis C virus (HCV) Ab and HIV Ab results was confirmed by Western Blotting. Results: A total number of 232 patients were enrolled (111 females and 121 males), among whom HBsAg and HIV Ab were both negative. Positive HBS Ab was reported in 222 subjects (95.7%) and 19 cases (8.2%) had positive HBC Ab. Immunity to hepatitis B was the result of vaccination in 87.5% of cases. Hepatitis C antibody was positive in 14 cases (6%). Finally, a significant relationship was found between HCV infection and blood transfusion done before 1996. Conclusions: High rate of hepatitis C was found to be due to the lack of screening for HCV Ab among blood donors before 1996. The negative HBS Ag can be justified by regular hepatitis B vaccination program in patients with thalassemia. The lack of HIV infection was concluded to be attributed to the low prevalence of this virus in the general population and blood donors as well as proper screening methods.

Frequency of Thalassemia and Its Association with Hepatitis C Infection in Local Population of Pakistan

“…Besides the disconsolation and helplessly tiring routine of blood transfusions and its associated therapy, it becomes quite alarming when thalassemia patients get infected with hepatitis virus. 1,7 Because of precarious CBC values, decreased and continuously fluctuating hemoglobin level and very young age of the patient, it is not appreciable for the accustomed interferon therapy. 19…”

“…Documentation from various geographical regions of Iran likewise exhibited the HCV infection up to 55.5% in thalassemia patients. 7 Studies of Hsu et al 8 and Jia et al 9 evaluated infectious viral proteins of HCV and HBV comprehensively, and concluded that these viral proteins have a complicated and multidimensional role in the hepatocellular carcinoma development by means of promoting angiogenesis, activation of oncogenes, stimulation of epithelial mesenchymal transition, and increasing the vascular invasion.…”