Sero-Molecular Detection of Transfusion Transmissible Infections Among Thalassemic Patients in Pakistan

Muhammad Ali Rathore; Mohammad Abdul Naeem; Anum Javed Abbasi; Eijaz Ghani; Saifullah Khan Niazi; Misbah Noor

doi:10.51253/pafmj.v74i3.6706

Authors

Muhammad Ali Rathore Department of Virology, Armed Forces Institute of Transfusion/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
Mohammad Abdul Naeem Department of Hematology, Armed Forces Institute of Transfusion/National University of Medical Sciences (NUMS) Rawalpindi, Pakistan https://orcid.org/0000-0002-6037-2063
Anum Javed Abbasi Department of Microbiology, Armed Forces Institute of Transfusion/National University of Medical Sciences (NUMS) Rawalpindi
Eijaz Ghani Department of Virology, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Saifullah Khan Niazi Department of Virology, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Misbah Noor Department of Virology, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i3.6706

Keywords:

Beta-Thalassemia, Nucleic acid amplification technique, Transfusion-transmitted infection

Abstract

Objective: To assess the frequency of molecular markers along with serological markers of Hepatitis B virus, Hepatitis C virus and Human Immunodeficiency Virus among multi-transfused beta-thalassemia patients.

Study Design: Cross-sectional study.

Place and Duration of Study: Armed Forces Institute of Transfusion, Rawalpindi Pakistan, from Apr to Jul 2020.

Methodology: A total of 105 beta-thalassemia patients were included in this study. Demographic information and frequency of transfusion was noted. Serological markers were detected using chemiluminescence microparticle immunoassay while molecular markers were identified using real-time polymerase chain reaction.

Results: Among 105 beta-thalassemia patients, 61(58.1%) were males and 44(41.9%) were females. The age range was from 2-34 years with a mean age of 11.8±6.4 years. Seropositivity and Nucleic Acid Testing reactivity was observed in 29(27.6%) and 16(15.2%) patients respectively. The frequency of hepatitis C Virus (HCV) antibodies and Ribonucleic Acid (RNA) was highest among infected patients while none of the patient was found to be reactive for anti-HIV and HIV-RNA. Viremia was detected in 12(11.4%) out of 29 seropositive patients and in 4(3.8%) out of 76 seronegative patients.

Conclusion: Hepatitis C Virus was the most prevalent in beta-thalassemia patients followed by Hepatitis B Virus and Human Immunodeficiency Virus. The serology should be augmented with NAT to detect viremia in seronegative cases as well as seropositive cases. The NAT will also help in early identification and treatment of infected patients and improve quality of life of these patients.

Downloads

Download data is not yet available.

References

Taher AT, Weatherall DJ, Cappellini MD. Thalassaemia. Lancet 2018; 391: 155-167.

https://doi.org/10.1016/S0140-6736(17)31822-6

De Sanctis V, Soliman AT, Elsefdy H, Soliman N , Bedair E, Fiscina B, et al. Bone disease in β thalassemia patients: past, present and future perspectives. Metabolism 2018; 80: 66-79.

https://doi.org/10.1016/j.metabol.2017.09.012

Kattamis A, Forni GL, Aydinok Y, Viprakasit V. Changing patterns in the epidemiology of β-thalassemia. Eur J Haematol 2020; 105(6): 692-703.

https://doi.org/10.1111/ejh.13512

Yasmeen H, Hasnain S. Epidemiology and risk factors of transfusion transmitted infections in thalassemia major: a multicenter study in Pakistan. Hematol Transfus Cell Ther 2019; 41: 316-323.

https://doi.org/10.1016/j.htct.2019.03.008

Ali S, Mumtaz S, Shakir HA, Shakir HA, Khan M , Tahir HM , et al. Current status of beta-thalassemia and its treatment strategies. Mol Genet Genomic Med 2021; 9(12): e1788.

https://doi.org/10.1002/mgg3.1788

Ghani E, Rathore MA, Khan SA. Trends in human immunodeficiency virus seroprevalence in blood donors in northern Pakistan. Public Health 2016; 131: 71-74.

https://doi.org/10.1016/j.puhe.2015.10.010

Adeleke AS, Fasola FA, Fowotade A. Comparative Analysis of Rapid Test and Enzyme Linked Immunosorbent Assay for Screening of Blood Donors for Hepatitis B Surface Antigen Seropositivity. West Afr J Med 2021; 38(1): 19-23.

Ahmed-Kiani R, Anwar M, Waheed U, Asad MJ, Abbasi S, Abbas Zaheer H, et al. Epidemiology of transfusion transmitted infection among patients with β-Thalassaemia Major in Pakistan. J Blood Transfus 2016; 8135649.

https://doi.org/10.1155/2016/8135649

Mishra K, Shah A, Patel K, Ghosh K, Bharadva S. Seroprevalence of HBV, HCV and HIV-1 and Correlation with Molecular Markers among Multi-Transfused Thalassemia Patients in Western India. Mediterr J Hematol Infect Dis 2020; 12(1): e2020038.

https://doi.org/10.4084/MJHID.2020.038

Mukherjee K, Bhattacharjee D, Chakraborti G. Prevalence of hepatitis B and hepatitis C virus infection in repeatedly transfused thalassemics in a tertiary care hospital in eastern India. Int J Research Med Sci 2017; 5(10): 4558-4562.

http://doi.org/ 10.18203/ 2320-6012.ijrms20174596

Hossain B, Selimuzzaman, Khan W, Tawfique M, Rahman F. Prevalence of Hepatitis C Virus Infection in Multi-transfused Thalassaemia Patients in Bangladesh. J Enam Med Col 2018.7; 8(1): 16-19.

Jafroodi M, Davoudi-Kiakalayeh A, Mohtasham-Amiri Z, Pourfathollah AA, Haghbin A. Trend in Prevalence of Hepatitis C Virus Infection among β-thalassemia Major Patients: 10 Years of Experience in Iran. Int J Prev Med 2015; 6:89.

https://doi.org/10.4103/2008-7802.164832

Kadhim KA, Baldawi KH, Lami FH. Prevalence, Incidence, Trend, and Complications of Thalassemia in Iraq. Hemoglobin 2017; 41(3): 164-168.

https://doi.org/10.1080/03630269

Atwa ZT, Abdel Wahed WY. Transfusion transmitted infections in frequently transfused thalassemic children living in Fayoum Governorate, Egypt: Current prevalence and risk factors. J Infect Public Health 2017; 10(6): 870-874.

https://doi.org/10.1016/j. jiph.2017.02.012

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: e0178883.

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

Al Kanaani Z, Mahmud S, Kouyoumjian SP, Abu-Raddad. The epidemiology of hepatitis C virus in Pakistan: systematic review and meta-analyses. R S Open Sci 2018; 5: 180257.

https://doi.org/10.1098/rsos.180257

Keechilot CS, Shenoy V, Kumar A, Biswas L, Vijayrajratnam S, Dinesh K, et al. Detection of occult hepatitis B and window period infection among blood donors by individual donation nucleic acid testing in a tertiary care center in South India. Patho Global Health 2016; 110: 287-291.

https://doi.org/10.1080/20477724.2016.1248171

Di Marco V, Capra M, Angelucci E, Borgna-Pignatti C, Telfer P, Harmatz P, et al. Management of chronic viral hepatitis in patients with thalassemia: recommendations from an international panel. J American Society Hematol 2010; 116: 2875-2883. https://doi.org/ 10.1371/journal.pone.0220852

Premawardhana AP, Mudiyanse R, De Silva ST, Jiffry N, Nelumdeniya U, de Silva U, et al. A nationwide survey of hospital-based thalassemia patients and standards of care and a preliminary assessment of the national prevention program in Sri Lanka. PloS One 2019; 14: e0220852.

https://doi.org/ 10.1371/journal.pone.0220852

Ahmed A, Hashmi FK, Khan GM. HIV outbreaks in Pakistan. Lancet HIV 2019; 6: 418.

https://doi.org/10.1016/S2352-3018(19)30179-1

Al-Moshary M, Al-Mussaed E, Khan A. Prevalence of transfusion transmitted infections and the quality of life in β-thalassemia major patients. Cureus 2019; 11(11): e6129.

https://doi.org/10.7759/cureus.6129

Harfouche M, Chemaitelly H, Kouyoumjian SP, Mahmud S, Chaabna K, Al Kanani Z, et al. Hepatitis C virus viremic rate in the middle east and north africa: systematic synthesis, meta-analyses, and meta-regressions. PloS one 2017; 12: e0187177.

https://doi.org/ 10.1371/journal.pone.0187177

Waheed U, Abdella YE, Noor e Saba MA, Farooq JU, Arshad A, Zaheer H, et al. Evaluation of screening effectiveness of hepatitis B surface antigen and anti-HCV rapid test kits in Pakistan. J Lab Phys 2019; 11: (4): 369-372.

https://doi.org/10.4103/JLP.JLP_172_19