Hepatitis A and B infections in transfusion-dependent thalassaemia from endemic areas

A M Li1, W K Chang

  • 1Department of Paediatrics, Hong Kong University.

The aim of this study was to determine the prevalence of previous hepatitis A virus (HAV) and B virus (HBV) infection which is in 64 transfusion-dependent (TD) patients with thalassaemia including 26 patients who were transfused before blood donors were screened for HBV. Serial blood samples taken from these 64 patients and 10 non-TD beta-thalassaemia intermedia patients during a 3 year period, were tested for antibody to HAV (anti-HAV), hepatitis B surface antigen (HBsAg), antibody to HBsAg (anti-HBs), antibody to core antigen (anti-HBc) and when indicated, antibody to Delta virus (anti-Delta) and HBV DNA. Liver function tests were performed also. Similar tests were conducted on 50 donor blood units. None of the 64 TD patients had evidence of past HAV infection, but 50% of blood donors had evidence of past infection (P less than 0.001). Only 2 brothers and their mother were positive for HBsAg, and 38 patients (59.4%) had persisting HBV antibodies compared with 26% of blood donors (P less than 0.001). Our TD thalassaemic patients acquired passive immunity from donor plasma, which protected them against HAV and possibly modified the outcome of HBV infection.

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