Torres M C M R, Pereira L M M B, Ximenes R A A, Araújo A S, Secaf M, Rodrigues S S, Bezerra A C S, Conceição I B, Valença M I B, Martinelli A L C
Hemocentro Caruaru, Fundação de Hematologia e Hemoterapia de Pernambuco, HEMOPE, Caruaru, PE, Brasil.
Braz J Med Biol Res. 2003 Mar;36(3):323-9. doi: 10.1590/s0100-879x2003000300006. Epub 2003 Mar 7.
Patients with sickle-cell anemia submitted to frequent blood transfusions are at risk of contamination with hepatitis C virus (HCV). Determination of HCV RNA and genotype characterization are parameters that are relevant for the treatment of the viral infection. The objective of the present study was to determine the frequency of HCV infection and the positivity for HCV RNA and to identify the HCV genotype in patients with sickle-cell anemia with a history of blood transfusion who had been treated at the Hospital of the HEMOPE Foundation. Sera from 291 patients were tested for anti-HCV antibodies by ELISA 3.0 and RIBA 3.0 Chiron and for the presence of HCV RNA by RT-PCR. HCV genotyping was performed in 19 serum samples. Forty-one of 291 patients (14.1%) were anti-HCV positive by ELISA and RIBA. Both univariate and multivariate analysis showed a greater risk of anti-HCV positivity in those who had started a transfusion regime before 1992 and received more than 10 units of blood. Thirty-four of the anti-HCV-positive patients (34/41, 82.9%) were also HCV RNA positive. Univariate analysis, used to compare HCV RNA-negative and -positive patients, did not indicate a higher risk of HCV RNA positivity for any of the variables evaluated. The genotypes identified were 1b (63%), 1a (21%) and 3a (16%). A high prevalence of HCV infection was observed in our patients with sickle-cell anemia (14.1%) compared to the population in general (3%). In the literature, the frequency of HCV infection in sickle-cell anemia ranges from 2 to 30%. The serological screening for anti-HCV at blood banks after 1992 has contributed to a better control of the dissemination of HCV infection. Because of the predominance of genotype 1, these patients belong to a group requiring special treatment, with a probable indication of new therapeutic options against HCV.
患有镰状细胞贫血且频繁输血的患者有感染丙型肝炎病毒（HCV）的风险。HCV RNA的测定和基因型特征分析是与病毒感染治疗相关的参数。本研究的目的是确定HCV感染的频率、HCV RNA的阳性率，并鉴定在HEMOPE基金会医院接受治疗且有输血史的镰状细胞贫血患者中的HCV基因型。通过ELISA 3.0和RIBA 3.0 Chiron检测了291例患者血清中的抗HCV抗体，并通过RT-PCR检测了HCV RNA的存在情况。对19份血清样本进行了HCV基因分型。291例患者中有41例（14.1%）ELISA和RIBA检测抗HCV呈阳性。单因素和多因素分析均显示，1992年前开始输血治疗且接受超过10单位血液的患者抗HCV阳性风险更高。34例抗HCV阳性患者（34/41，82.9%）HCV RNA也呈阳性。用于比较HCV RNA阴性和阳性患者的单因素分析未表明所评估的任何变量有更高的HCV RNA阳性风险。鉴定出的基因型为1b（63%）、1a（21%）和3a（16%）。与一般人群（3%）相比，我们的镰状细胞贫血患者中HCV感染的患病率较高（14.1%）。在文献中，镰状细胞贫血中HCV感染的频率为2%至30%。1992年后血库对HCV抗体进行血清学筛查有助于更好地控制HCV感染的传播。由于基因型1占主导，这些患者属于需要特殊治疗的群体，可能需要新的抗HCV治疗方案。
