The prevalence of heptitis b and c among Thalassemia major patients in kerman, iran, and the Role of transfusion in infection acquisition

Abstract

INTRODUCTION: Regular blood transfusions for patients with thalassemia major have improved their overall survival, but carry a definite risk of being infected with blood born viruses especially hepatitis B and C. Nowadays, it has remained as main health concern about these patients. In this study, we tried to define the prevalence rate of hepatitis B and C and survey the related risk factors among a group of thalassemic patients in Iran.

METHODS: We evaluated 100 thalassemics in Kerman, Iran in July 2002. The initial data were recorded and the sera were tested for HBV seromarkers, anti-HCV Ab and anti-HIV Ab. Anti-HCV Ab was detected using ELISA-2nd generation and confirmed by RIBA-2nd generation. Second samples tested to measure hemoglobin and serum ferritin levels.

RESULTS: Therty-one patients were anti-HCV-Ab (ELISA) positive. In 11 cases the RIBA results were missed and among 20 cases remained, 14 patients were anti-HCV Ab (RIBA) positive. Six patients (6%) were HBs Ag positive and there was no anti-HIV positive case. Mean of patients' age, and transfusion duration were significantly higher in anti-HCV seropositive patients (P=0.000, P=0.000 repectively). Furthermore, HCV prevalence rate has significantly dropped after applying anti-HCV Ab screening in blood donors (22.4% vs. 0%, P=0.006), and there was no new infected case thereafter. There were no significant associations between anti-HCV Ab seropositivity and sex, vaccination against HBV, and family history of hepatitis. The mean of hemoglobin and serum ferritin did not differ between two groups.

CONCLUSION: Hepatitis C prevalence rate is very high among thalassemics. Screening of blood donors seems to be able to decrease prevalence and incidence rate of HCV infection effectively.