Prevalence of Hepatitis C Virus Infection in Multi-transfused Thalassaemia Patients in Bangladesh

Hossain, Belayet; Selimuzzaman,; Khan, W; Tawfique, Muhammad; Rahman, Farjana

doi:10.3329/jemc.v8i1.35430

Cited by 5 publications

(5 citation statements)

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“…Our results showed a seroprevalence of 26%, though, a variable range of HCV prevalence has been reported in prior studies (5.5% to 68.2%) [19,22,[26][27][28][29][30]. Current prevalence of HCV in TM patients is 13.6% in Iran, 14.7% in Bangladesh and 11-30% in India [32][33][34]. This significant prevalence of HCV in Pakistan is predominantly due to a lack of centralized system, specialized care centers, voluntary remunerated blood donations (VNRDs), low socioeconomic status of patients, and improper blood donor screening [35].…”

Section: Discussionsupporting

confidence: 49%

Prevalence of Transfusion Transmissible Infections in Beta-Thalassemia Major Patients in Pakistan: A Systemic Review

Ehsan¹,

Wahab²,

Anwer³

et al. 2020

Cureus

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β-thalassemia major (TM) is one of the most prevalent inherited hemoglobinopathies in Pakistan. It has one of the highest prevalence of transfusion-dependent TM patients globally, with an estimated greater than 100,000 active cases. Blood transfusions (BT) are essential in the management of severe TM; it is critical to have a safe BT to reduce the risk of transfusion transmissible infections (TTIs). Frequent blood transfusions in these patients increase their risk of acquiring TTIs compared to the general population. We performed a systematic literature search to identify studies related to the TTIs and transfusion-related infections in Pakistan from January 1, 2010, to January 31, 2020. The search was conducted using PubMed and PakMediNet, with initial search retrieved 981 studies. Among these, 166 studies met the inclusion criteria, and only 14 studies met the final criteria for qualitative synthesis. Analysis of 14 studies (n = 3786) showed the seroprevalence of hepatitis B virus (HBV) of 3.13% (0.66% to 7.4%) and hepatitis C virus (HCV) of 26% (5.56% to 68.2%). There were only two studies that reported HIV seroprevalence of 0% and 0.5% (n = 6). The rate of seropositivity for HBV and HCV was directly related to the number of transfusions, higher ferritin levels, and older age groups. There was an increase in the HCV rate with the increasing age of patients. Thalassemia patients, who were older than ten years of age, had an HCV rate of 22% compared to only 8.4% in patients younger than ten years of age. A comparison of HCV in healthy donors vs. thalassemia patients showed a rate of 1.9% vs. 13.1% for TM patients. The majority of the patients were males (51% to 88%). The seroprevalence of TTIs was higher in males than in females (73.4% vs. 26.6%). On average, a single TM patient is exposed to at least 17 different donors annually, requiring 1-2 transfusions every month. Our study highlights that the prevalence of transfusion-transmitted infections, especially HCV, is alarmingly higher (26%) in the TM population than in the general population. There is limited data regarding the prevalence of HIV, syphilis, and malaria in this population. This is mainly due to a fragmented system of blood transfusion, weak regulations, and lower rates of voluntary blood donations. These findings warrant better health measures to improve the blood donation system and specialized care for TM patients.

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Section: Discussionsupporting

confidence: 49%

Prevalence of Transfusion Transmissible Infections in Beta-Thalassemia Major Patients in Pakistan: A Systemic Review

Ehsan¹,

Wahab²,

Anwer³

et al. 2020

Cureus

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“…It is well recognized that, with proper regulation driven by policy makers, transfusion transmitted infections are markedly reduced [5]. Pakistan is a low resource country: the pooled prevalence of HCV in β-thalassemia patients in Pakistan is higher than that in Iran [46] (19%) or Bangladesh [47] (14.7%). The findings of this study should act as a major safety alert for decision and policy-makers in the Pakistani health sector.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of hepatitis C virus infection in β-thalassemia patients in Pakistan: a systematic review and meta-analysis

2020

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Background: Hepatitis C virus infection is the most commonly reported bloodborne infection in Pakistan. Frequent blood transfusions in β-thalassemia patients expose them to a high risk of HCV infection. The purpose of this paper is to summarise the current data on the prevalence of HCV infection in β-thalassemia patients in Pakistan by using a systematic review and meta-analysis. Methods: PubMed, EMBASE, Web of Sciences, the Cochrane Library, Directory of Open Access Journal and local databases were systematically searched for studies published between January 1st, 1995 and May 31st, 2019. Metaanalysis was performed using the DerSimonian and Laird random-effects models with inverse variance weighting. The presence of publication bias was tested by Egger test, and the methodological quality of each included article was evaluated by the STROBE. Results: We identified a total of 229 potential studies, of which 27 studies were finally considered in the metaanalysis. The pooled prevalence of HCV in β-thalassemia patients in Pakistan was 36.21% (95% CI: 28.98-43.75%) based on 5789 β-thalassemia patients, but there was considerable heterogeneity. Meta-analysis estimated the HCV prevalence among the β-thalassemia patients at 45.98% (95% CI: 38.15-53.90%) in Punjab, 31.81% (95% CI: 20.27-44.59%) in Sindh, and 28.04% (95% CI: 13.58-45.26%) in Khyber Pakhtunkhwa. Meta-regression analysis showed that geographical location was a key source of heterogeneity. Conclusions: The pooled prevalence of HCV in β-thalassemia patients in Pakistan was more than one in three, and higher than in neighbouring countries. It varies regionally within the country. With the use of standard prevention procedures during blood transfusion, the risk of HCV transmission in β-thalassemia patients could be controlled and the prevalence of HCV in β-thalassemia patients reduced.

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“…It is well recognized that, with proper regulation driven by policy makers, transfusion transmitted infections are markedly reduced 5 . Pakistan is a low resource country: the prevalence of HCV in β -thalassemia patients in Pakistan is higher than that in Iran 46 (19%) or Bangladesh 47 (14.7%). The findings of this study should act as a major safety alert for decision and policy-makers in the Pakistani health sector.…”

Section: Discussionmentioning

confidence: 97%

The prevalence of hepatitis C virus (HCV) infection in β-thalassemia patients in Pakistan: a systematic review and meta-analysis

Akhtar

Nasir

Shah

et al. 2019

Preprint

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Objective: Hepatitis C virus (HCV) infection is the most commonly reported bloodborne infection in Pakistan. Frequent blood transfusions in β-thalassemia patients expose them to a high risk of HCV infection. The purpose of this paper is to summarize the current data on the prevalence of HCV infection among β-thalassemia patients in Pakistan by using a systematic review and meta-analysis. Design: Systematic review and meta-analysis. Participants: β-thalassemia patients in Pakistan. Data sources: Following PRISMA guidelines, a comprehensive literature search in PubMed/MEDLINE and EMBASE was performed to identify published articles reporting on the prevalence of HCV among β-thalassemia patients in Pakistan. Only English language articles were considered. Two independent authors selected studies. The methodological quality of the included studies was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: The search conceded a total of 138 studies, of which 27 studies were finally considered for meta-analysis. The pooled prevalence of HCV in β-thalassemia patients in Pakistan was 36.21% (95% CI: 28.98-43.75%) based on 5,789 β-thalassemia patients, but there was considerable heterogeneity. Meta-analysis estimated the HCV prevalence among the β-thalassemia patients at 45.98 % (95% CI: 38.15-53.90%) in Punjab, 31.81% (95% CI: 20.27-44.59%) in Sindh, and 28.04% (95% CI: 13.58-45.26%) in Khyber Pakhtunkhwa. Meta-regression analysis showed that geographical location was a key source of heterogeneity. Conclusions: The pooled prevalence of hepatitis C virus among β-thalassemia patients in Pakistan was 36.21%, but varies regionally within the country. The prevalence is higher than in neighboring countries. With the use of standard prevention procedures during blood transfusion, the risk of HCV transmission among β-thalassemia patients could be controlled hence prevalence of HCV in β-thalassemia patients could be reduced.

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Prevalence of Hepatitis C Virus Infection in Multi-transfused Thalassaemia Patients in Bangladesh

Cited by 5 publications

References 5 publications

Prevalence of Transfusion Transmissible Infections in Beta-Thalassemia Major Patients in Pakistan: A Systemic Review

Prevalence of Transfusion Transmissible Infections in Beta-Thalassemia Major Patients in Pakistan: A Systemic Review

The prevalence of hepatitis C virus infection in β-thalassemia patients in Pakistan: a systematic review and meta-analysis

The prevalence of hepatitis C virus (HCV) infection in β-thalassemia patients in Pakistan: a systematic review and meta-analysis

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