Epidemiology of hepatitis B, hepatitis C, and human immunodeficiency virus infecions in patients with beta-thalassemia in Iran: a multicenter study.
BACKGROUND
Though regular blood transfusion improves the overall survival of patients with beta-thalassemia, it carries a definite risk of infection with blood-borne viruses. We carried out this multicenter study to provide epidemiologic data on hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection among Iranian beta-thalassemic patients. Moreover, HCV infection-associated risk factors were investigated in this population.


METHODS
Seven hundred and thirty-two patients with beta-thalassemia major or beta-thalassemia intermedia, selected from five provinces of Iran including Tehran (n = 410), Kerman (n = 100), Qazvin (n = 95), Semnan (n = 81), and Zanjan (n = 46), were enrolled in this study. Using ELISA, their sera were tested for HBsAg, HBcAb, HBsAb, HCVAb, and HIVAb. The positive HCVAb results were confirmed by RIBA-2nd generation.


RESULTS
The study sample consisted of 413 males and 319 females, with a mean +/- SD age of 17.9 +/- 9.0 years. One hundred forty-one (19.3%) patients were HCVAb positive; 11 (1.5%) were HBsAg positive. No one was HIVAb positive. Univariate analysis showed that beta-thalassemia major (P = 0.01), older age (P = 0.001), longer transfusion duration (P = 0.000), HBsAg seropositivity (P = 0.03), and higher serum ferritin level (P = 0.002) were significantly associated with a higher prevalence of HCV. Furthermore, the prevalence of HCV infection dropped significantly after the implementation of blood donors screening (22.8% vs. 2.6%; P = 0.000). Using multivariate analysis, beta-thalassemia major (P = 0.002), age (P < 0.001), serum ferritin level (P < 0.001), as well as consumption of unscreened blood (P = 0.003), were independent factors associated with HCV infection.


CONCLUSIONS
The prevalence of HCV infection is much higher among Iranian beta-thalassemic patients as compared with HBV and HIV infections. Routine screening of donated blood for HCV is highly recommended.
Mirmomen
Shahram
S
Gastrointestinal and Liver Research Center, Tehran University of Medical Sciences, Iran.
Alavian
Seyed-Moayed
SM
Hajarizadeh
Behzad
B
Kafaee
Jafar
J
Yektaparast
Babak
B
Zahedi
Mohammad-Javad
MJ
Zand
Vahid
V
Azami
Ali-Akbar
AA
Hosseini
Mir Mohammad-Ali
MM
Faridi
Ali-Reza
AR
Davari
Kambiz
K
Hajibeigi
Bashir
B
D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology*; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology* / Q000821:virology*; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007223:Infant; D007492:Iran; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D017086:beta-Thalassemia / Q000150:complications / Q000453:epidemiology / Q000821:virology*