Mirmomen Shahram, Alavian Seyed-Moayed, Hajarizadeh Behzad, Kafaee Jafar, Yektaparast Babak, Zahedi Mohammad-Javad, Zand Vahid, Azami Ali-Akbar, Hosseini Mir Mohammad-Ali, Faridi Ali-Reza, Davari Kambiz, Hajibeigi Bashir
Gastrointestinal and Liver Research Center, Tehran University of Medical Sciences, Iran.
Arch Iran Med. 2006 Oct;9(4):319-23.
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.
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.
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.
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.
尽管定期输血可提高β地中海贫血患者的总体生存率，但确实存在感染血源性病毒的风险。我们开展了这项多中心研究，以提供有关伊朗β地中海贫血患者中乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）感染的流行病学数据。此外，还对该人群中与HCV感染相关的危险因素进行了调查。
从伊朗五个省份（包括德黑兰（n = 410）、克尔曼（n = 100）、加兹温（n = 95）、塞姆南（n = 81）和赞詹（n = 46））选取了732例重型β地中海贫血或中间型β地中海贫血患者纳入本研究。采用酶联免疫吸附测定法（ELISA）检测他们血清中的乙肝表面抗原（HBsAg）、乙肝核心抗体（HBcAb）、乙肝表面抗体（HBsAb）、丙肝抗体（HCVAb）和艾滋病毒抗体（HIVAb）。HCVAb检测结果阳性者采用第二代重组免疫印迹法（RIBA-2）进行确认。
研究样本包括413例男性和319例女性，平均年龄±标准差为17.9±9.岁。141例（19.3%）患者HCVAb检测呈阳性；11例（1.5%）患者HBsAg检测呈阳性。无人HIVAb检测呈阳性。单因素分析显示，重型β地中海贫血（P = 0,01）、年龄较大（P = 0.001）、输血时间较长（P = 0.000）、HBsAg血清学阳性（P = 0.03）以及血清铁蛋白水平较高（P = 0.002）与HCV感染率较高显著相关。此外，实施献血者筛查后，HCV感染率显著下降（22.8%对2.6%；P = 0.000）。多因素分析显示，重型β地中海贫血（P = 0.002）、年龄（P < 0.001）、血清铁蛋白水平（P < 0.001）以及输注未筛查血液（P = 0.003）是与HCV感染相关的独立因素。
与HBV和HIV感染相比，伊朗β地中海贫血患者中HCV感染率要高得多。强烈建议对捐献血液进行HCV常规筛查。
