The Prevalence of Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus Infections among β-thalassemia Major: A Multicenter Survey in Lorestan, West of Iran

Although regular frequent blood transfusion improves overall survival of multi-transfused patients like β-thalassemic ones, it carries a definite risk of infection with blood-borne viruses such as viral hepatitis. This study was done to determine seropositivity of hepatitis B virus (HBV), hepatitis C virus (HCV), and Human Immunedeficiency Virus (HIV) infections among β-thalassemia major patients, and estimate the infection-associated risk factors among them.
In this cross-sectional study, serums of 143 patients with β-thalassemia major were collected from 2015 to 2016. Enzyme-linked immunosorbent assay (ELISA) was performed for the detection of antibodies to hepatitis C virus anti-HCV, hepatitis B surface antigen HBs Ag, hepatitis B core antigen (anti-HBC), and human immunodeficiency virus (anti-HIV). The positive anti-HCV and anti-HIV results were confirmed by RIBA assay and Western blot. Demographic information and risk factors were collected and analyzed.
The findings showed that the prevalence rate of anti-HCV was 4.2%; while no patients were detected with HIV and HBV infections. Among the six anti-HCV positive patients, 5 (3.5%) were positive for anti-HCV using RIBA test. The prevalence of HCV seropositivity was higher in patients with sexual exposure risk (p= 0.04). There was no significant difference between sex and other risk factors such as history of splenectomy and different city with anti-HCV seropositivity (p=0.6 and 0.51, respectively). Moreover, the number of blood transfusions received by HCV positive thalassemia patients was significantly higher than that of negative anti-HCV thalassemia patients (p=0.001).
The prevalence of HCV infection was much higher among β-thalassemic patients comparing with HBV and HIV infection patients. Older age, blood transfusion, and sexual risk were associated with HCV seropositivity. Routine screening of donated blood for HCV is highly recommended. More study is needed to assess continuous screening of blood products for patients with risks of exposure to HCV.