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

Abstract

Background and Objective: Thalassemia major or βeta-thalassemia is a hereditary blood disorder, necessitating continuous blood transfusions. Frequent blood transfusions often result in the development of hepatitis, hepatocellular carcinoma, acquired immunodeficiency syndrome (AIDS) and many other infectious diseases. Incidence of infection of viral hepatitis in thalassemia patients is majorly associated with infections in the donor population. The objective of this study was to ascertain the frequency of HCV infection in patients with thalassemia in Pakistan.Methods: This study was conducted from January 2015 to September 2018 in various sections of Punjab and Sindh, Pakistan. A total number of 439 patients were enrolled in this study, samples of blood from the patients were collected and their Anti-HCV antibodies were evaluated by enzyme-linked immunosorbent assay (ELISA); HCV-RNA genome presentation was assessed by HCV-nested-real time-polymerase chain reaction (RT-PCR) for the confirmation.Results: It was found that major population of the thalassemia patients were male (63%). While the female thalassemia population was almost twice in Sindh province as compared to Punjab. In present study, n = 187 were detected positive among those n = 168 were confirmed by PCR. Only 47% thalassemia patients were found vaccinated against hepatitis B whereas all HCV positive patients were not vaccinated, and (84.96%) thalassemia patients were from the family of first cousin marriage. The patients which are not vaccinated also had significant chance to acquire the viral infection (P < 0.001). Moreover there could be some gender and environmental or geographical factors associated with thalassemia that are yet to be explored in detail. Conclusion:Thalassemia patients carry major risk for acquiring transfusion associated infection.

Clinical Profile of Proptosis in Dr. M. Djamil General Hospital Padang

“…Elderly (elderly) as many as 12.5% (6 subjects) and the age group of children (children) as much as 8.33% (4 subjects). These results are comparable to the findings of Khan et al 7 and Sharma et al 8 , where they found a 2:1 male-to-female ratio. In that study, a high percentage of males were traumatized and infected, which was attributed to the statement that males were more involved in trauma-risky work and aggressive play.…”

“…In that study, a high percentage of males were traumatized and infected, which was attributed to the statement that males were more involved in trauma-risky work and aggressive play. 7,8 However, Zaidi For adults, the most common causes of unilateral and bilateral proptosis are thyroid-related eye disease or Graves' ophthalmopathy. In children, orbital cellulitis is the most common cause, whereas bilateral proptosis is most likely due to neuroblastoma and leukemia.…”

Evaluation of conventional renal function tests in β-thalassemia major patients in Nineveh province

“…βthalassemia major, was described in 1925 by Cooley and Lee, is a life threatening anemia which is characterized by ineffective erythropoiesis, bone marrow expansion, and increase destruction of defective red blood cells (RBCs) (4,5) . The resultant anemia and other complications can be corrected with repeated regular blood transfusion program (6) ; unfortunately, such blood transfusion program will exert its own problems concerning iron overload (7) . The iron overload may have adverse effects on several organs including heart, liver, endocrine glands, lungs, and kidneys (4,5,8) .…”

“…Deferroxamine, an iron chelating agent given by subcutaneous infusion is the standard iron chelating agent used since the late 1960s (6,9,10) . Many researchers studied the different complications that arise from the disease and its treatment; however, there are only a few studies on the effects of thalassemia and deferroxamine on renal functions (7,11) . Renal damage can be attributed to chronic anemia, iron over load and deferroxamine therapy (12) .…”