title: Epidemiology of hepatitis B, hepatitis C, and human immunodeficiency virus infecions in patients with beta-thalassemia in Iran: a multicenter study.
abstract: 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.
authors.affiliation: Gastrointestinal and Liver Research Center, Tehran University of Medical Sciences, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Mirmomen
authors.forename: Seyed-Moayed
authors.initials: SM
authors.lastname: Alavian
authors.forename: Behzad
authors.initials: B
authors.lastname: Hajarizadeh
authors.forename: Jafar
authors.initials: J
authors.lastname: Kafaee
authors.forename: Babak
authors.initials: B
authors.lastname: Yektaparast
authors.forename: Mohammad-Javad
authors.initials: MJ
authors.lastname: Zahedi
authors.forename: Vahid
authors.initials: V
authors.lastname: Zand
authors.forename: Ali-Akbar
authors.initials: AA
authors.lastname: Azami
authors.forename: Mir Mohammad-Ali
authors.initials: MM
authors.lastname: Hosseini
authors.forename: Ali-Reza
authors.initials: AR
authors.lastname: Faridi
authors.forename: Kambiz
authors.initials: K
authors.lastname: Davari
authors.forename: Bashir
authors.initials: B
authors.lastname: Hajibeigi
mesh_terms: 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*