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A study of hepatitis B and C prevalence and liver function in multiply transfused thalassemic and their parents
T N Williams1, B Wonke, S M Donohue
1Department of Hematology, Whittington Hospital, London.
Insights
Hepatitis C virus (HCV) poses a greater long-term threat than hepatitis B virus (HBV) in Indian children with beta thalassemia major. Enhanced screening for HCV in donated blood and continued HBV vigilance are recommended.
Area of Science:
- Hepatology
- Virology
- Pediatric Hematology
Background:
- Beta-thalassemia major patients are at risk of viral infections.
- Hepatitis B virus (HBV) and hepatitis C virus (HCV) are significant concerns in this population.
Purpose of the Study:
- To assess the prevalence of HBV and HCV infections in children with beta-thalassemia major and their parents in Delhi, India.
- To compare the long-term threat posed by HCV versus HBV in this patient group.
Main Methods:
- Cross-sectional study conducted in Delhi, India, in January 1990.
- Serological testing for anti-HCV antibodies, evidence of HBV infection, and hepatitis B surface antigen (HBsAg).
- Analysis of data from 54 patients with beta-thalassemia major and 90 parents.
Main Results:
- Prevalence of anti-HCV antibodies was 11.1% in patients and 2.2% in parents.
- Evidence of HBV infection was found in 66.6% of patients and 28.9% of parents.
- HBsAg positivity was 7.4% in patients and 11.1% in parents.
Conclusions:
- HCV infection presents a more significant long-term risk for chronic liver disease in beta-thalassemia major patients compared to HBV.
- Recommendations include implementing HCV screening for donated blood and strengthening HBV screening and immunization protocols.
Abstract:
A series of clinics were conducted in Delhi, India, in January, 1990. Of 54 patients with beta thalassemia major (mean age 7.6 years), 11.1% (6 out of 54) tested positive for antibodies to hepatitis C virus (anti HCV antibodies) and 66.6% (36 out of 54) showed evidence of hepatitis B virus (HBV) infection. Only 7.4% (4 out of 54) were hepatitis B surface antigen (HBsAg) positive. Of their parents, 2.2% (2 out of 90) tested positive for anti HCV antibodies, 28.9% (26 out of 90) showed evidence of previous HBV infection and 11.1% (10 out of 90) were HBsAg positive. We argue that HCV constitutes a greater long term threat than HBV in these patients due to the higher incidence of chronic liver disease. We would advocate the introduction of HCV screening of donated blood as well as reinforcing the importance of HBV screening and immunization.