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Hepatitis B and hepatitis C in multitransfused children
Insights
This study investigated viral hepatitis in 75 multitransfused children, finding high rates of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections. Post-transfusion hepatitis was observed in 15% of cases, highlighting significant transfusion-related risks.
Area of Science:
- Pediatrics
- Hepatology
- Infectious Diseases
Background:
- Multitransfused children, particularly those with hematological disorders like thalassemia major, are at increased risk of transfusion-transmitted infections.
- Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are significant concerns in this vulnerable population.
- Understanding the prevalence of viral hepatitis markers is crucial for implementing effective screening and prevention strategies.
Purpose of the Study:
- To determine the prevalence of Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Hepatitis D virus (HDV) infections in multitransfused children.
- To assess the incidence of post-transfusion hepatitis (PTH) in this cohort.
- To evaluate liver function in children with transfusion-related viral infections.
Main Methods:
- Cross-sectional study involving 75 multitransfused children (2-13 years old) at a New Delhi hospital.
- Serological testing for Hepatitis B surface antigen (HBsAg), antibody to Hepatitis B core antigen (Anti-HBc), antibody to Hepatitis C virus (Anti-HCV), and antibody to Hepatitis D virus (Anti-HDV).
- Liver function tests (LFTs) were performed on all participants; IgM anti-HAV testing was done in hepatitis patients.
Main Results:
- Hepatitis B surface antigen (HBsAg) positivity was 31%, with significantly higher rates in males (40%) than females (15%).
- Antibody to Hepatitis B core antigen (Anti-HBc) was positive in 84% of patients, indicating past or present HBV infection.
- Antibody to Hepatitis C virus (Anti-HCV) was detected in 21% of patients, and 4% were positive for Anti-HDV. Post-transfusion hepatitis (PTH) was diagnosed in 15% of the children, with 57% of these PTH cases testing positive for Anti-HCV.
Conclusions:
- Multitransfused children exhibit a high seroprevalence of HBV and HCV infections, underscoring the risk of transfusion-transmitted viral hepatitis.
- The significant prevalence of Anti-HBc and Anti-HCV suggests a substantial burden of chronic HBV and HCV infections in this population.
- HCV appears to be a major contributor to post-transfusion hepatitis in this cohort, necessitating improved blood safety measures and vigilant monitoring.
Abstract:
The study was conducted on 75 multitransfused children aged between 2 and 13 years who attended the Department of Paediatrics, LNJPN Hospital, New Delhi from July 1990 to July 1991. These included 64 cases of thalassaemia major, 4 cases of haemophilia, 3 patients of acute lymphatic leukaemia and one each of acute myeloid leukaemia, aplastic anemia, chronic idiopathic thrombocytopenic purpura and acute haemorrhagic pancreatitis. HBsAg was tested in all, Anti-HBc was tested in 44 patients and Anti-HCV in 43 patients. Anti HDV was tested in HBsAg positive patients and IgM anti-HAV was tested in patients suffering from hepatitis. Liver function tests were evaluated in all patients. HBsAg was positive in 31% of patients; 40% of males and 15% of females were HBsAg positive, the difference being statistically significant. 84% of patients were Anti-HBc positive, 21% were anti HCV positive, 4% were Anti HDV positive. 15% of the patients had post transfusion hepatitis. Anti HCV was present in 57% of the hepatitis patients; none had anti-HAV IgM.