Seroprevalence and clinical characteristics of viral hepatitis in transfusion-dependent thalassemia and hemophilia patients

Abstract

Background/AimsTransfusion dependent subjects are at a great risk of viral hepatitis infection. We aimed to evaluate the prevalence and factors associated with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among transfusion-dependent patients in Taiwan.MethodsA total of 140 patients (67 thalassemic patients, 70 hemophilic patients, two patients with hereditary spherocytosis and one patient with von Willebrand disease) were prospectively enrolled to evaluate the prevalence and factors associated with viral hepatitis and spontaneous HCV clearance. All patients were tested for HBV and HCV serology and virology. Two consecutive serum samples, at least 1 year apart, were collected to clarify HCV seroclearance.ResultsThe seropositivity rate of hepatitis B surface antigen (HBsAg), HCV antibody (anti-HCV), and both HBsAg/anti-HCV were 6.4%, 45.7% and 5%, respectively. Logistic regression analysis of factors associated with anti-HCV seropositivity included age (odds ratio/95% confidence interval [OR/CI]: 1.12/1.07–1.18, P<0.001), serum alanine aminotransferase (ALT) (OR/CI: 1.04/1.02–1.06, P<0.001) and platelet counts (OR/CI: 0.995/0.991–0.998, P = 0.002). Age was the only factor independently associated with HBsAg seropositivity (OR/CI: 1.08/1.02–1.14.4, P = 0.007). Compared to patients born before 1992, the seroprevalence of HCV among thalassemic patients decreased dramatically in those born after 1992 (46.0% vs. 11.8%, p = 0.012). The seroprevalence of HCV among hemophilic patients also decreased significantly when comparing patients born before 1987 to those born after 1987 (79.5% vs. 11.5%, p<0.001). Similarly, the seroprevalence of HBV decreased significantly in the post-vaccination cohort compared to its counterpart (13.1%, vs. 1.3%, p = 0.005). The spontaneous clearance of HCV was observed in 25.4% (15/59) of patients, and ALT was the only factor associated with it (OR/CI 0.98/0.96–1.00, P = 0.02).ConclusionsBoth HBV and HCV infections are prevalent among transfusion-dependent thalassemic and hemophilic patients in Taiwan. Nevertheless, seroprevalence decreased significantly and dramatically for HCV after universal blood screening and for HBV after implementation of a universal mass vaccination program.

Prevalence and risk factors associated with hepatitis C among Brazilian male patients with haemophilia: A long‐term follow‐up

“…22 However, this result is slightly lower than that found in other populations with haemophilia worldwide, as recently described in the United States Middle West countries (48.3%) and Australia (52.0%). 7,13,14,16,17 Patients with haemophilia were at high risk of post-transfusion viral hepatitis because of the large use of plasma-derived products before the mid to late 1980s, when effective methods of viral inactivation of coagulation factors concentrates were introduced.…”

“…Additional steps towards blood safety in Brazil were taken with the introduction of anti‐HCV screening of the donated blood in 1992/1993 and with the implementation of nucleic acid tests (NAT) in 2011. Since then, the rate of HCV infection among Brazilian patients with haemophilia has decreased significantly as observed in other countries …”

“…Since then, the rate of HCV infection among Brazilian patients with haemophilia has decreased significantly as observed in other countries. 7,[12][13][14] Nevertheless, the high HCV prevalence among patients with haemophilia around the world persists until now. 7,13,[15][16][17] A Brazilian national report supported by data collected from 2005 to 2007 showed that 34.9% and 29.7% of Brazilian patients with haemophilia A and B, respectively, were hepatitis C antibody (anti-HCV)-positive.…”

Frequency of Hepatitis B, Hepatitis C and HIV (Human Immunodeficiency Virus) in Thalassemia Major Patients Having Multiple Transfusion

“…240 milyondan fazla insanın kronik HBV infeksiyonu olduğu bilinmektedir (7) . Ülkemizde farklı çalışmalarda HBsAg sıklığı % 0.8 ile % 5.7 arasında değiş-mektedir.…”

“…Kronik karaciğer hastalığının en büyük nedenleri arasındadır. Dünya genelinde 185 milyonun üzerinde anti-HCV pozitif insan olduğu tahmin edilmektedir (7) . Ülkemizde yapılan epidemiyolojik çalışmalarda anti-HCV pozitifliği % 0.9, Kızılay Kan Merkezi'nin 2008-2012 yılları arasındaki verilerinde anti-HCV pozitifliği % 0.02-0.004 arasında bildirilmiştir (18) .…”