Occult HBV infection in multi transfused thalassemia patients

To determine the prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infection in multitransfused thalassemic patients, with an aim to further highlight the need for donor screening strategy with supplementary molecular diagnostic tools for high risk population.

The study was conducted in 174 thalassemic subjects from Thalassemia unit of Central Red Cross Blood Bank, Cuttack, Odisha, India. Sero molecular diagnosis was followed to detect antigen, antibody and DNA in the study subjects.

Prevalence of antibody to Hepatitis C, HBsAg, Anti HBs and Anti HBc were found to be 3.4 %, 0.5 %, 30.4 % and 21.8 % respectively. HBV seropositivity increased with increase in number of transfusions. Anti HBc was 12 %, 26.8 % and 71.4 % in subjects who received <40, 40-80 and >80 units of transfusions respectively. HBV DNA was detected in 50 % (3/6) of subjects having anti HBc as the only marker (Occult HBV infection). More so, it was detected in 16.12 % (5/31) of cases who were sero positive for both Anti HBs and Anti HBc.

These results indicate that thalassemic subjects need detailed screening of transfusion products. Fifty percent of occult HBV infection is a major concern suggesting inclusion of viral DNA amplification test along with antigen/antibody detection.