Prevalence of hepatitis A and B infections in multiply transfused thalassaemic patients.

Papaevangelou, G.; Frösner, G. G.; Economidou, J.; Parcha, Siva; Róumeliotou, A.

doi:10.1136/bmj.1.6114.689

Cited by 36 publications

(16 citation statements)

References 11 publications

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“…Viral agents implicated in transfusion hepatitis [10] and iron overload [11] result ing from the high transfusion requirements are considered the main causes.…”

Section: Introductionmentioning

confidence: 99%

Chronic Liver Disease in Transfusion-Dependent Thalassemia: Liver Iron Quantitation and Distribution

Virgiliis¹,

Cornacchia²,

Sanna³

et al. 1981

Acta Haematol

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The quantitative and/or qualitative distribution of liver iron was assessed in 81 transfusion-dependent thalassemia major patients with chronic liver disease (36 with chronic active hepatitis, 23 with chronic persistent hepatitis, 22 with siderosis). Viral marker studies showed only 3 cases with both HBsAg and anti-HBc posiüvity in the serum, while the others had anti-HBc and anti-HBs or only anti-HBs or no B viral markers. A significantly higher iron overload was found in chronic hepatitis, particularly chronic active hepatitis, than in siderosis. This increased iron overload may be due to less intensive chelation treatment, higher intestinal absorption secondary to lower mean Hb levels, and/or to liver inflammation-depedent iron deposition. The liver iron overload in turn may facilitate the development or persistence of chronic progressive liver disease.

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“…Viral agents implicated in transfusion hepatitis [10] and iron overload [11] result ing from the high transfusion requirements are considered the main causes.…”

Section: Introductionmentioning

confidence: 99%

Chronic Liver Disease in Transfusion-Dependent Thalassemia: Liver Iron Quantitation and Distribution

Virgiliis¹,

Cornacchia²,

Sanna³

et al. 1981

Acta Haematol

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“…These observations suggest that Th minor subjects are more susceptible to becoming chronic carriers of hepatitis B and NANB viruses, as are polytransfused Th major pa tients [2,3,18,19]. Therefore, repeated blood transfusion and iron overload do not seem to be the prevalent factors facilitating the development of chronic liver damage.…”

Section: Resultsmentioning

confidence: 82%

Chronic Viral Hepatitis in Thalassemic Liver Disease

Pastore¹,

Tannoia²,

Angarano³

et al. 1983

Vox Sanguinis

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To evaluate the effective role of hepatitis viruses in thalassemic (Th) liver disease, we carried out a long-term study in 42 subjects with nontransfusion-dependent Th minor hospitalized for an episode of acute viral hepatitis. 10 patients had serologic evidence of hepatitis A, 23 of hepatitis B and 9 of hepatitis non-A, non-B. In the follow-up chronic hepatitis was detected histologically in 5/23 patients with hepatitis B and 5/9 with hepatitis non-A, non-B. All hepatitis A patients recovered completely. The prevalence in 7 out of 10 patients with chronic hepatitis of piecemeal necrosis and of inflammatory changes over hepatic siderosis and fibrosis evidenced a determinant role of chronic viral infection in the development of liver damage in these patients. Thus, heterozygous nontransfusion-dependent Th patients seem to have a high risk of developing a chronic inflammatory liver disease especially after an episode of non-A, non-B hepatitis. Therefore, in our geographical area, chronic hepatitis of viral origin should be taken into account, among other pathogenetic factors, in many cases of cryptogenic thalassemic liver disease.

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“…Transfusionassociated hepatotropic infections, especially HCV infection, and hepatic siderosis can act either synergistically or independently in promoting chronic liver disease, and they may induce cellular damage through similar oxidative pathways [11] . There are no recent data on HAV epidemiology of that group of patients [12][13][14] , and blood transfusion is not considered a significant predisposing factor for HAV infection. In this study, adult beta-thalassemic patients were found to have significantly higher frequency of anti-HAV IgG antibodies than healthy subjects matched for age and sex in the same geographic area.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown lower prevalence of anti-HAV antibodies in multiply transfused thalassemic patients [12][13][14] . However, in these studies the mean age of thalassemic patients was much lower than that of our population and it is known that seroprevalence rates of HAV are increasing with age.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of anti-HAV antibodies in multitransfused patients with beta-thalassemia

Siagris

Kouraklis-Symeonidis²,

Konstantinidou³

et al. 2008

WJG

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AIM:To detect the prevalence of anti-HAV IgG antibodies in adult multitransfused beta-thalassemic patients. METHODS:We studied 182 adult beta-thalassemic patients and 209 controls matched for age and sex from the same geographic area, at the same time. Anti-HAV IgG antibodies, viral markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection were evaluated. RESULTS:Anti-HAV IgG antibodies were detected more frequently in thalassemic patients (133/182; 73.1%) than in healthy controls (38/209; 18.2%, P < 0.0005). When we retrospectively evaluated the prevalence of anti-HAV IgG antibodies in 176/182 (96.7%) thalassemic patients, whose medical history was available for the previous ten years, it was found that 83 (47.2%) of them were continuously anti-HAV IgG positive, 16 (9.1%) acquired anti-HAV IgG antibody during the previous ten years, 49 (27.8%) presented anti-HAV positivity intermittently and 28 (15.9%) were anti-HAV negative continuously. CONCLUSION:Multitransfused adult beta-thalassemic patients present higher frequency of anti-HAV IgG a n t i b o d i e s t h a n n o r m a l p o p u l a t i o n o f t h e s a m e geographic area. This difference is difficult to explain, but it can be attributed to the higher vulnerability of thalassemics to HAV infection and to passive transfer of anti-HAV antibodies by blood transfusions.

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Prevalence of hepatitis A and B infections in multiply transfused thalassaemic patients.

Cited by 36 publications

References 11 publications

Chronic Liver Disease in Transfusion-Dependent Thalassemia: Liver Iron Quantitation and Distribution

Chronic Liver Disease in Transfusion-Dependent Thalassemia: Liver Iron Quantitation and Distribution

Chronic Viral Hepatitis in Thalassemic Liver Disease

Prevalence of anti-HAV antibodies in multitransfused patients with beta-thalassemia

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