Prevalence of occult hepatitis C virus infection in Iranian patients with beta thalassemia major

Abstract

Occult hepatitis C virus infection (OCI) is a new pathological form of chronic hepatitis virus (HCV) infection characterized by the presence of HCV RNA in liver biopsy and/or peripheral blood mononuclear cell (PBMC) specimens and the absence of HCV RNA and anti-HCV antibodies (Abs) in plasma samples. β-thalassemia major is a hereditary recessive blood disease with deficiency in the hemoglobin beta chain. Thalassemic patients need blood transfusion therapy; repeated blood transfusion increases the risk of viral blood-borne infection. The aim of this study was to determine the prevalence of OCI in Iranian patients with β-thalassemia major. From February 2015 to November 2015, a total of 147 Iranian patients with β-thalassemia major were enrolled in this cross-sectional study. After extraction of viral RNA from the plasma and PBMC samples, HCV genomic RNA in the specimens was amplified by RT-nested PCR using primers from the 5'-UTR. The HCV genotypes of the positive specimens were tested using the RFLP assay. To confirm the HCV genotypes, the 5'-UTR fragment was amplified and cloned into the pJET1.2/blunt cloning vector and then sequenced. Out of 147 patients, 106 (72.1 %) were negative for anti-HCV Abs and HCV RNA. HCV RNA was found in PBMC specimens of six (5.7 %) patients, from a total of 106 patients with undetectable plasma HCV RNA and anti-HCV Abs. Therefore, six out of 106 patients had OCI. HCV genotyping revealed that three patients were infected with HCV subtype 1b, two patients were infected with HCV subtype 3a, and one patient was infected with HCV subtype 1a. These results revealed that Iranian patients with beta-thalassemia major might have OCI. Therefore, it seems that the design of a study to identify this infection in patients with β-thalassemia major would provide valuable information.

Hepatitis C Virus RNA Strands Detection in Peripheral Blood Mononuclear Cells Legitimizes Virus Eradication in Negative Serum PCR Naïve and Post-treatment Patients

“…Cryptogenic occult HCV infection (OCI) is defined by the absence of serum RNA and IgG antibodies, and the presence of genomic RNA strand(s) in PBMCs. Prevalence of OCI is around 3.3% in the healthy population 17–19. The increasing clinical demands for evaluating spontaneous and post-treatment HCV cure rates strongly argue for the need to assess cellular HCV and to determine its clinical significance.…”

Prevalence of Hepatitis C Virus Antibodies among Beta-Thalassemia Major Patients in Kurdistan Province, Iran

“…HCV is distributed throughout the world with varying prevalence rates, affecting about more than 3% of the world's population. This virus can account for approximately 20% of all cases of acute hepatitis, 80% of cases of chronic hepatitis, 40% of cirrhosis cases, 70% of cases of hepatocellular carcinoma, and 30% of cases of liver transplantation (1)(2)(3).…”

“…Some groups, such as patients with haemophilia, thalassemia, renal diseases (under hemodialysis), and intravenous drug use are at a high risk of HCV infection. No vaccine is available against HCV infection, and the accessible antiviral drugs are long-acting, difficult to use, expensive, and ineffective for patients (1)(2)(3).…”

The Presence of Autoantibodies to Cytoplasmic Rod and Ring Particles in the Serum of Patients with Chronic Hepatitis C Virus Infection

“…It is a major cause of chronic liver disease, possibly leading to liver cirrhosis and hepatocellular carcinoma (1, 2). In the majority of the HCV infected patients, the infection becomes chronic, but in 14% - 45% of the cases, the virus is spontaneously cleared (3).…”