Frequency of Hepatitis B or C in Patients of Beta Thalassemia Registered in the Thalassemia Centre, Pak Emirates Military Hospital, Rawalpindi

Kiran Zeb; Asma  Razzaq; Farooq  Ikram

doi:10.51253/pafmj.v75i4.5643

Authors

Kiran Zeb Department of Paediatric, Pak Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Asma Razzaq Department of Paediatric, Pak Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Farooq Ikram Department of Paediatric, Pak Emirates Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i4.5643

Keywords:

β-Thalassemia Major; Hepatitis B; Hepatitis C, Thalassemia

Abstract

Objective: To determine the frequency of Hepatitis B or C and associated factors in patients with beta Thalassemia registered in the Thalassemia Centre, Pak Emirates military hospital, Rawalpindi.

Study Design: Cross sectional study.

Place and Duration of Study: Thalassemia Centre, Pak Emirates military hospital, Rawalpindi Pakistan, from Aug 2019 to Apr 2020.

Methodology: This study involved 280 children of both genders aged between 2-12 years managed for beta-Thalassemia Major and having transfusions at the or Thalassemia Centre. Laboratory testing for hepatitis B and C was performed on all the patients by the ELISA method. Age, gender, duration of receiving transfusions, and ALT levels were also associated with the seropositivity of any of the viruses.

Results: The Mean age of the patients was 7.26±4.26 years. There were 150 (53.5%) male and 130 (46.5%) female patients in the study patients. Out of 280 patients, 238(85.0%) were negative for both viruses, 9(3.2%) were hepatitis B positive, and 33(11.8%) were hepatitis C positive. Raised ALT levels (p-value <0.001) and increased frequency of red cell transfusions (p-value=0.006) had a significant relationship with seropositivity of any of the viruses.

Conclusion: Seropositivity of hepatitis B and C was not an uncommon finding among our target population. Hepatitis C was more common of the two viruses studied. Raised ALT levels among these patients should not be ignored, and patients with increased duration of being transfused should be considered at high risk for acquiring these viral infections.

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References

1. Needs T, Gonzalez-Mosquera LF, Lynch DT. Beta Thalassemia. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020.

2. Betts M, Flight PA, Paramore LC, Tian L, Milenković D, Sheth S et al. Systematic Literature Review of the Burden of Disease and Treatment for Transfusion-dependent β-Thalassemia. Clin Ther 2020; 42(2): 322‐337.e2.

https://doi.org/10.1016/j.clinthera.2019.12.003

3. Alzahrani RA, Almutairi OM, Alghoraibi MS, Alabdulwahed MS, Abaalkhail MK, ALhawish MK, et al. Quality of life in transfusion-dependent thalassemia patients. J Taibah Univ Med Sci 2017; 12(5): 465‐470.

https://doi.org/10.1016/j.jtumed.2017.05.006

4. Vichinsky E, Neumayr L, Trimble S, Giardina, PJ, Cohen AR, Coates T, et al. Transfusion complications in thalassemia patients: a report from the Centers for Disease Control and Prevention (CME). Transfusion 2014; 54(4): 972‐971.

https://doi.org/10.1111/trf.12348

5. Ragab LA, Hamdy MM, Shaheen IA, Yassin RN. Blood transfusion among thalassemia patients: A single Egyptian center experience. Asian J Transfus Sci 2013; 7(1): 33‐36.

https://doi.org/10.4103/0973-6247.106728

6. Shah T, Hussain W, Ali N, Sardar S, Muhammad I, Rahman MU, et al. Frequency distribution and risk factors of hepatitis B virus and hepatitis C virus infections among thalassemia patients: a regional study. Eur J Gastroenterol Hepatol 2019; 31(2): 248‐252.

https://doi.org/10.1097/MEG.0000000000001287

7. Singh H, Pradhan M, Singh RL, Phadke S, Naik SR, Aggarwal R, et al. High frequency of hepatitis B virus infection in patients with beta-thalassemia receiving multiple transfusions. Vox Sang 2003; 84(4): 292‐299.

https://doi.org/10.1046/j.1423-0410.2003.00300.x

8. Amarapurkar DN, Kumar A, Vaidya S, Murti P, Bichile SK, Kalro RH, et al. Frequency of hepatitis B, C and D and human immunodeficiency virus infections in multi-transfused thalassemics. Indian J Gastroenterol 1992; 11(2): 80‐81.

9. Saeed U, Waheed Y, Ashraf M, Waheed U, Anjum S, Afzal MS. Estimation of Hepatitis B Virus, Hepatitis C Virus, and Different Clinical Parameters in the Thalassemic Population of Capital Twin Cities of Pakistan. Virol Res Treat 2015; 6(1): 11-16.

https://doi.org/10.4137/VRT.S31744

10. Kantharaj A, Chandrashekar S. Coping with the burden of thalassemia: Aiming for a thalassemia free world. Glob J Transfus Med 2018; 3(1): 1-5.

https://doi.org/10.4103/GJTM.GJTM_19_18

11. Al-Sharifi LM, Murtadha J, Shahad A, Mohammed Y, Sura J, Waleed Z, et al. Prevalence of hepatitis B and C in thalassemic patients and its relation with type of thalassemia, frequency of blood transfusion, and spleen status. Med J Babylon 2019; 16(2): 108-111. https://doi.org/10.4103/MJBL.MJBL_6_19

12. Lee YK, Kim HJ, Lee K, Park SH, Song SH, Seong MW, et al. Recent progress in laboratory diagnosis of thalassemia and hemoglobinopathy: a study by the Korean Red Blood Cell Disorder Working Party of the Korean Society of Hematology. Blood Res 2019; 54(1): 17‐22.

https://doi.org/10.5045/br.2019.54.1.17

13. Bhattacharyya KK, Biswas A, Gupta D, Sadhukhan PC. Experience of hepatitis C virus seroprevalence and its genomic diversity among transfusion-dependent thalassemia patients in a transfusion center. Asian J Transfus Sci 2018; 12(2): 112‐116.

https://doi.org/10.4103/ajts.AJTS_73_17

14. Marsella M, Ricchi P. Thalassemia and hepatocellular carcinoma: links and risks. J Blood Med 2019; 10(1): 323‐334.

https://doi.org/10.2147/JBM.S186362

15. Cappellini MD, Cohen A, Eleftheriou A, Piga A, Porter J, Taher A et al. Guidelines for the Clinical Management of Thalassaemia. 2nd Revised edition. Chapter 8, Nicosia (CY): Thalassaemia International Federation; 2008.

16. Biswas A, Firdaus R, Saha K, Chowdhury P, Bhattacharya D, Bhattacharyya M. Post-transfusion hepatitis C virus infection among β-thalassaemic individuals with associated clinical parameters. Indian J Med Res 2018; 147(6): 581‐587.

https://doi.org/10.4103/ijmr.IJMR_127_16

17. Jang TY, Lin PC, Huang CI, Liao YM, Yeh ML, Zeng YS, et al. Seroprevalence and clinical characteristics of viral hepatitis in transfusion-dependent thalassemia and hemophilia patients. PLoS One 2017; 12(6): e0178883.

https://doi.org/10.1371/journal.pone.0178883

18. Akhtar S, Nasi JA, Hinde A. The prevalence of hepatitis C virus infection in β-thalassemia patients in Pakistan: a systematic review and meta-analysis. BMC Public Health 2020; 20(1): 587-595. https://doi.org/10.1186/s12889-020-8414-5