Seroprevalance of hepatitis-c infection in multi-transfused thalassemic children: study from a West Indian tertiary care center

Abstract

Background: To study the prevalence of hepatitis-C virus infection in multi-transfused thalassemic children and to correlate these patients with age, number of transfusion, serum ferritin levels and transaminases levels.Methods: This study was conducted in the Department of Pediatrics of a Teaching Institute of Rajasthan. It was a hospital based cross sectional study, conducted over a period of 12 months (April 2016- March 2017). Blood sample for Ant-HCV antibody detection was taken at time of follow-up visit in the subspeciality clinic. These samples were processed in central laboratory for hep-C antibody, serum ferritin and transaminases levels. Anti-HCV antibody detection was done by BI-DOT machine. HCV RNA PCR was done to access viral load in all positive cases.Results: A total of 300 patients were enrolled in the study. There were 219 (73%) males and 81 (27%) females. The mean age of the study group was 7.59±3.6 years (range 1.5-18years). At the time of our study 277 (92.4%) cases were on one or the other chelating agent whereas 23 (7.6%) cases were not taking any kind of chelation therapy. Out of 300 patients, 72(24%) cases tested positive for anti HCV antibody. Out of 72 patients only 36(12%) patients had detectable viral load in RNA PCR. Mean age of the HCV positive cases (9.58±3.28) years was higher as compared to HCV negative cases (6.98±3.54). Maximum HCV positivity 20/38 (52.6%) was seen in 12-18 year age group; followed by 33/76 (43.4%) in 9-12yr age group. Significant association was observed between advancing age and prevalence of hepatitis C in thalassemia major patients (p=0.002). The number of blood transfusions received by anti-HCV positive children (Avg. Transfusion 185±98.40 ml/kg/year) was significantly higher than that by anti-HCV negative patients (Avg. Transfusion 102.8±71.20) (p value<0.001). Maximum HCV positive cases 33 (45.83%) had total transfusions >200 in a year followed by 15 (20.83%) cases with 151-200 transfusions (p<0.001).Conclusions: Despite ELISA screening of blood donors, our study demonstrated high (24%) prevalence of transfusion transmitted hepatitis-C virus in thalassemic children which increases with increasing number of transfusions, it also correlates with rising serum ferritin level and SGPT level.

Prevalence of HIV, hepatitis B and hepatitis C infections among patients with thalassemia attending a tertiary care (rural) hospital

“…When compared to statistics available through peer-reviewed studies from India,[ 15 16 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 ] incidence of HIV-1, HBV and HCV in our thalassemia cohort was on the higher side [ Table 7 ]. Most recent reports from our country document the high prevalence of these TTIs due to the use of molecular tests in addition to serological tests like in our study [ Table 7 ].…”

Socio-demographic association with confirmed hepatitis C virus infection: A cross-sectional analysis from a teaching institute

“…Chakraborty A (2015)[ 25 ] found the age group of less than 15 years to be the most affected. Another study by Agrawal S[ 26 ] found maximum positive cases of hepatitis C among the 12–18 year age group followed by the 9–12 year age group and these were predominantly found among thalassemia patients who had multiple blood transfusions. Contrarily, Supriya L,[ 24 ] in their study, conducted at Manipur observed maximum hepatitis C cases among the 41–50 year age group in males and 31–40 year age group in females.…”