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Blood transfusion, Hepatitis-B, Hepatitis-C, HIV-1, Beta-thalassemia, NAT test and ELISA
Background: Blood transfusion is a lifesaving therapy for patients with hemoglobinopathies. However, the need of frequent transfusion carries the risk of transfusion-transmitted infections (TTIs). This study was aimed to determine the seroprevalence of Hep-B, Hep-C and HIV-1infections among the multi-transfused Beta-thalassemic patients and correlate the same with NAT testing.
Methods: Total 196 patients with Beta-thalassemia were included in the study. Patients were screened for the presence of viral markers by third generation ELISA test as well as for viral DNA/RNA by NAT.
Results: Among these 196 multi-transfused Beta-thalassemia patients, 32.1% were females and 67.8% were males. A total of 100 (51.1%) patients were found to be anti-HCV antibody reactive, while HCV-RNA was positive in 66 (33.7 %) of the 196 patients tested. There were 6 (3.1%) patients reactive for anti-HIV-1 antibody, while 8 (4.1%) were positive for HIV-RNA. There were only 3 (1.5%) patients that were found to be reactive for HBsAg, however 5 (2.5%) were positive for HBV-DNA. Two (1%) patients had co-infection of anti-HCV antibody and HBsAg,whereas 6 patients were found co-infected by NAT testing, in-which 3 (1.5%) were positive for HBV-DNA and HCV-RNA, 1 (0.5%) was positive for HIV-RNA and HBV-DNA, and 2 (1%) had co-infection of HIV-RNA and HCV RNA.
Conclusion: Prevalence of HCV among multi-transfused Beta-thalassemia patients is significantly higher than the normal population. On the other hand, the study showed low prevalence of HBV. Therefore, a follow-up schedule and administration of booster dose of HBV vaccine is strongly recommended for thalassemia patients. To the best of our knowledge, this is the foremost work that shows prevalence of HIV, HBV and HCV in thalassemia patients using both serology and molecular markers in Western India.