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Hepatitis C Genotyping And Viral Titers Among Patients With Beta Thalassemia Major in Al-Najaf Governorate - Iraq
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| Author:
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AYMEN ABD. ALBAKAA, FARIS M. AL-HARIS, ALAA JUMAAH MNAJI NASRAWI, DR. KAMAL ROTHAN AL SAAIDY
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| Abstract:
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Background: Beta thalassemia syndromes are a group of hereditary disorders characterized by a genetic deficiency in the synthesis of beta-globin chains. One option for treatment patients with thalassemia major includes chronic and regular transfusion therapy in order to maintain hemoglobin at an adequate level. But, transfusion-related viral infection produces large problems in these patients and may produces significant morbidity and mortality. These viruses may include hepatitis C virus (HCV), hepatitis B virus (HBV), Cytomegalovirus (CMV),and human immune virus (HIV) are common among thalassemic patients.
In hepatitis C virus (HCV), many genotypes and subtypes are present , and they are variable in severity ,viral titers, and geographical distribution.
Aim: To study the prevalence of hepatitis C virus infection in patients with Beta thalassemia major in AL- Najaf city, and to determine their base line viral titers, their genotypes and the possible relationship between HCV infection in those patients with other risk factors.
Patients and methods: This cross-sectional study was conducted at the thalassemia center in AL-Zahraa Teaching Hospital for Maternity and Children in AL- Najaf city, from 1st September 2018 to the end of October 2019. A total of 356 patients pre-diagnosed with B-thalassemia major who’s registered in thalassemia center were surveyed with ELISA test to detect HCV. we did Quantitative Real Time PCR (RT-qPCR) for Beta thalassemia major patients with positive ELISA samples to confirm HCV infection and to quantitate base line viral titer for those patients. Serum samples which showed HCV RNA, and positive Real-Time PCR technique were examined by Reverse Transcription PCR (RT-PCR) to detect Genotypes &their subtypes.
Medical records and some data of Beta thalassemia major (B-TM) patients with positive ELISA test for HCV infection were analyzed to study a possible risk factor.
Results: This study revealed that (28) patients (7.86 %) were seropositive for HCV from a total number of (356) thalassemia major patients. From those with ELISA positive , only (16) patients (57.14 %) were PCR positive and (12) patients (42.85 %) were negative PCR assay .So the percent of patients with positive PCR from a total number of included thalassemia major patients was (4.49 % ) . Regarding genotypes: genotyp1A ( 81.25% ), genotype 4 ( 12.5% ) and mixed type 1c & 4 (6.25% ).Viral load range from 11 300 to 3 090 000 IU/ML , (mean = 1 236 982.9),( median = 1002500)
A significant difference between HCV infected group and those who are not infected in regard to age, ALT and AST ( P -value was 0.0009 ,0.000 and 0.04 respectively ) . Also there is a significant difference between HCV infected group and those who are not infected in regard to splenectomy and number of transfusions (p- value was 0.041 and 0.000 respectively ).A significant difference in regard to age between infected patients with high viral load and infected patients with low viral load groups (p-value =0.007).
Conclusion: The percentage of HCV infection among ß-TM patients in our center was16 (4.49 % ) patients. HCV genotype 1a is the commonest genotype in ß-TM patients in our center. The percent of HCV infected patients with genotype 1a with high base line viral load more than infected patients with low viral load.
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| Keyword:
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ß- thalassemia major, Hepatitis C, Viral Load, Genotypes.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2020.SP1.110
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