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Occult hepatitis C virus infection in patients with beta-thalassemia major: Is it a neglected and unexplained

Ahmad Ayadi1, Amir Hossein Nafari1, Shiva Irani1

  • 1Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran.

Journal of Cellular Biochemistry
|February 19, 2019
PubMed

Insights

Occult hepatitis C virus (HCV) infection (OCI) was found in 3.3% of Iranian beta-thalassemia major (BTM) patients. Host factors like uric acid levels, blood type, and specific IFNL3/IFNL4 genotypes were associated with OCI positivity.

Area of Science:

  • Virology
  • Hematology
  • Immunogenetics

Background:

  • Occult hepatitis C virus infection (OCI) is defined by the presence of HCV RNA in tissues or cells despite negative serum tests.
  • Beta-thalassemia major (BTM) patients require frequent blood transfusions, increasing susceptibility to infections like HCV.
  • Assessing OCI prevalence in BTM patients is crucial due to their heightened risk of transfusion-transmitted infections.

Purpose of the Study:

  • To determine the prevalence of OCI in Iranian patients with BTM.
  • To investigate the association between host factors and OCI positivity in this cohort.
  • To identify specific viral genotypes involved in OCI among BTM patients.

Main Methods:

  • Nested polymerase chain reaction (PCR) was used to detect HCV RNA in peripheral blood mononuclear cells (PBMCs) of 181 BTM patients with negative HCV markers.
  • Positive samples were genotyped using restriction fragment-length polymorphism (RFLP) and 5'-untranslated region sequencing.
  • Statistical analysis was performed to identify associations between OCI and host factors, including serum uric acid, ABO blood group, and IFNL3/IFNL4 polymorphisms.

Main Results:

  • A low prevalence of OCI was observed, with 3.3% (6 out of 181) of BTM patients testing positive for HCV RNA in PBMCs.
  • The predominant HCV genotypes identified were 1b (50%), followed by 1a (33.3%) and 3a (16.7%).
  • OCI positivity showed significant associations with higher serum uric acid levels (P=0.045) and specific ABO blood groups (P=0.032). Unfavorable IFNL3/IFNL4 genotypes were also linked to OCI.

Conclusions:

  • The study indicates a low frequency of OCI in Iranian BTM patients, but highlights the need for increased vigilance.
  • Host factors, including serum uric acid, ABO blood group, and IFNL3/IFNL4 genotypes, play a role in OCI susceptibility.
  • Further research is recommended to establish the definitive prevalence of OCI in this population and its clinical implications.

Keywords:
ABO blood groupsbeta-thalassemia majoroccult hepatitis C virus infectionserum uric acid

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