SEN virus genotype H distribution in β-thalassemic patients and in healthy donors in Iraq: Molecular and physiological study

Abstract

15The SEN virus (SENV) has been linked to transfusion-associated non-A-E hepatitis; however, 16 information regarding SENV infections in patients with thalassemia, particularly in those with 17 hepatitis virus co-infections, remains limited. This study investigated the frequency of SENV 18 (genotypes D and H) infections in Iraqi patients with thalassemia who were and were not 19 infected with hepatitis C virus (HCV). The study involved 150 β-thalessemia patients (75 with 20 HCV infections and 75 without) and 75 healthy blood donors. Patient levels of vitamins C and E, 21 liver function markers, and glutathione peroxidase (GPX) were determined. Recovered viral 22 nucleic acids were amplified using the conventional polymerase chain reaction (SENV DNA) or 23 the real-time polymerase chain reaction (HCV RNA) techniques. Only 10% of healthy donors 24 had evidence of SENV infection. Among patients with thalassemia, 80% and 77% of patients 25 with and without concurrent HCV infections, respectively, had SENV infections. DNA 26 sequencing analyses were performed on blood samples obtained from 29 patients. Patients with 27 thalassemia, particularly those with SENV infections, had higher levels of several enzymatic 28 liver function markers and total serum bilirubin (P < 0.05) than did healthy blood donors. Among 29 the examined liver function markers, only gamma-glutamyl transferase demonstrated 30 significantly higher levels in HCV-negative patients infected with SENV-H than in those 31 infected with SENV-D (P = 0.01). There were significantly lower vitamin C, vitamin E, and 32 glutathione peroxidase levels in patients than in healthy donors (P < 0.05), but only glutathione 33 peroxidase levels were significantly lower in HCV-negative thalassemia patients infected with 34 SENV than in those without SENV infections (P = 0.04). The SENV-H genotype sequences 35 were similar to the global standard genes in GenBank. These results increase our understanding 36 of the nature of the SENV-H genotype and the differential role of SENV-H infections, compared 37 to SENV-D infections, in patients with thalassemia, in Iraq. 39Author summary 40 In patients with β-thalassemia, regular blood transfusions increase patient survival but increase 41 the risk of acquiring blood-borne viral infections, especially viral hepatitis. The SEN virus 42 (SENV) is associated with non-A-E hepatitis but its exact role in the pathogenesis of liver 43 disease remains unknown. This study investigated the frequency of SENV infections among 3 44 Iraqi patients with thalassemia, with and without hepatitis C infections. The study revealed that 45 the prevalence of SENV infections is significantly higher in patients with β-thalassemia, 46 regardless of their hepatitis C infection status, than in a healthy population of blood donors. The 47 two most common genotypes of the virus (D and H) have generally similar physiological impacts 48 as both increase the levels of markers of hepatic dysfunction in thalassemia patients. However, 49SENV-H infections were...