Study of Hepatitis C Virus infection among multi-transfused patients with inherited β-globin synthesis gene defect, in the eastern region of India

Abstract

Post transfusion acquired HCV infection is common in high risk group individuals such as b-thalassemia patients who depend on regular blood transfusions. This study was conducted to determine the prevalence, genotype distribution, transmission dynamics and correlation of patients age and gender with spontaneous clearance of HCV in multi-transfused b-thalassemia patients, in the state of West Bengal, India. HCV RNA was first detected, using RT-PCR, from serum samples collected from HCV seropositive b-thalassemic individuals over five years. Viral RNA was further sequenced, and genotyped, using NCBI genotyping tool, for phylogenetic and phylogeographic studies using MEGA-X and BEAST package 1.10.0, respectively. Out of 777 HCV seropositive b-thalassemic patients, 503 (64.73%) were positive for HCV RNA, while 274 (35.26%) had spontaneously cleared the virus. Female thalassemic patients and patients belonging to ages 10-14 years, had a higher chance of spontaneously clearing the virus. The most prevalent HCV genotype in this study population was 3a (77.61%) followed by 1b (11.94%). Phylogeographic analyses revealed that the 3a strains migrated from countries like Pakistan, China Myanmar and Thailand whereas the 1b strains transmitted from Bangladesh and Myanmar. The prevalence of HCV infection is very high among Indian b-thalassemic patients, which necessitates a critical look into the prevailing transfusion practices and requires implementation of more rigid donor screening criteria to decrease the rate of transfusion transmitted HCV infection, especially in the highly susceptible thalassemic patients. The use of more sensitive NAT based assays for HCV detection in donor blood is a compressing need of the hour

Community-based transmission of hepatitis C in India: a systematic review

“…Many studies reported an association between injections drug user (IDU), female sex workers (FSW), men sex with men (MSM) and HCV, and some study reported associated risk patient; β-thalassemia, visceral leishmaniasis, jaundice, dialysis, three studies combined measure 12% prevalence in pregnant women, and also reported slum population and primitive groups with 6% prevalence (Table 2). 1,4,8,[14][15][16][17][18][19]20,22,23…”

“…The prevalence of active HCV infection in some of these transfusion centers was as high as 81%, because the South Asian countries, including India, have been derived by voluntary and paid blood donors. 3,4 HCV infection varies considerably from country to country, probably because of cultural factors and social habits that influence HCV transmission. Transfusion transmitted infections (TTIs) are a major problem associated with blood transfusion practices).…”