Hepatitis C Viral Infection Among Beta-Thalassemia Patients: A Study From the Centre for Excellence in Thalassemia and Other Blood Disorders

Abstract

BackgroundHepatitis C virus (HCV) is a single-stranded RNA virus, which is frequently transmitted through blood transfusions, contact with infected blood or blood products, and vertical transmission. Injectable drug abusers and transplant recipients are predisposed to HCV infection. It causes acute hepatitis, which may progress to chronic hepatitis, and in severe untreated cases, patients may develop cirrhosis and hepatocellular carcinoma (HCC). Since there is no vaccine available against HCV infection, prevention remains the mainstay, at least among the susceptible populations that include thalassemia patients. MethodsA prospective case-control study was conducted at the center for excellence in thalassemia and other blood disorders attached to the Prathima Institute of Medical Sciences (PIMS), a tertiary care teaching hospital at Karimnagar, Telangana, India. Blood samples of 100 beta-thalassemia patients and age-matched nonthalassemic persons were screened for antibodies against HCV by an enzyme-linked immunosorbent assay (ELISA) based rapid immunochromatographic method, and the chemiluminescence assay using the Abbott AxSYM (Abbott Laboratories, Abbot Park, IL, USA). During the same period, the prevalence of HCV was assessed among non-thalassemic patients attending in-patient and out-patient wards of PIMS hospital. ResultsOf the 100 cases of beta-thalassemia, 28 (28%) were HCV positive. All the age-matched non-thalassemic controls were negative for HCV antibodies. Among the positives, 20 (71%) were males, and eight (29%) were females. The prevalence of HCV among non-thalassemic patients attending the hospital during the same period was found to be 0.19%. ConclusionsHCV infection among the beta-thalassemia patients was abnormally high as compared to the others. Thalassemia patients are potentially predisposed to HCV infection and other blood-borne viral infections. Thorough screening of blood before transfusion is warranted. HCV infection may further increase the morbidity and mortality of beta-thalassemia patients and other patients with blood disorders who acquire the infection due to frequent blood transfusions.

Effects of Sirolimus treatment on patients with β‐Thalassemia: Lymphocyte immunophenotype and biological activity of memory CD4+ and CD8+ T cells

“…The major end points of the NCT03877809 clinical trial were not aimed to explore changes in the functionality of memory T cells of Sirolimus‐treated patients. 39 However, the possible effect of Sirolimus in β‐Thalassemia is intriguing, as recent reports have highlighted a high mortality rate in β‐Thalassemia patients affected by infectious bacterial and viral diseases, 41 , 42 , 43 , 44 , 45 , 46 probably due to co‐existing immune deficiencies. 47 , 48 , 49 Immune dysfunctions characterizing thalassemia patients include changes in lymphocyte subsets, such as the accumulation of suppressor T cells and the reduced proliferative capacity and numbers of T helper cells, as well as the defective activity of natural killer (NK) cells.…”

Prevalence of Hepatitis B and C in Patients of Thalassemia in Sargodha, Pakistan

“…In blood donors' seroprevalence for hepatitis B, C and HIV were 2.35%, 3.26% and 0.17% 14 . Although all patients of thalassemia major receiving blood transfusion are prone to acquire these infectious diseases but our study showed that the patients who receive transfusion frequently and in whom it started earlier are more liable to become positive than those in whom interval between transfusion is relatively increased to maintain haemoglobin 5 .…”

“…It's the hemoglobin H variety who is severely anemic and needs transfusion for whole life 3 . Blood transfusion in these patients is like two faces of a coin whose one side saves lives and keep the functions going on but on the other side it has devastating effects if goes unchecked 2,5 . One of the hazardous effects of transfusion is transmission of infectious diseases.…”

Noninvasive assessment and risk factors of liver fibrosis in pediatric patients with beta thalassemia major using transient elastography

“…9.4% of the cases in our study had HCV serology that was positive. While Mirzaei et al [17] reported a lesser percentage (3.4%), Al-Khabori et al [11], Elalfy et al [12], and Kandi et al [18] recorded greater percentages (38%, 82%, and 28%, respectively) of HCV antibody positive individuals. According to our research, having a positive HCV serology was associated with the severity of liver fibrosis (p value 0.05).…”