Bastani Mohammad-Navid, Bokharaei-Salim Farah, Keyvani Hossein, Esghaei Maryam, Monavari Seyed Hamidreza, Ebrahimi Mojtaba, Garshasebi Saba, Fakhim Shahin
Department of Virology, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.
HIV Laboratory of National Center, Deputy of Health, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.
Arch Virol. 2016 Jul;161(7):1899-906. doi: 10.1007/s00705-016-2862-3. Epub 2016 Apr 30.
Occult hepatitis C virus infection (OCI) is a new pathological form of chronic hepatitis virus (HCV) infection characterized by the presence of HCV RNA in liver biopsy and/or peripheral blood mononuclear cell (PBMC) specimens and the absence of HCV RNA and anti-HCV antibodies (Abs) in plasma samples. β-thalassemia major is a hereditary recessive blood disease with deficiency in the hemoglobin beta chain. Thalassemic patients need blood transfusion therapy; repeated blood transfusion increases the risk of viral blood-borne infection. The aim of this study was to determine the prevalence of OCI in Iranian patients with β-thalassemia major. From February 2015 to November 2015, a total of 147 Iranian patients with β-thalassemia major were enrolled in this cross-sectional study. After extraction of viral RNA from the plasma and PBMC samples, HCV genomic RNA in the specimens was amplified by RT-nested PCR using primers from the 5'-UTR. The HCV genotypes of the positive specimens were tested using the RFLP assay. To confirm the HCV genotypes, the 5'-UTR fragment was amplified and cloned into the pJET1.2/blunt cloning vector and then sequenced. Out of 147 patients, 106 (72.1 %) were negative for anti-HCV Abs and HCV RNA. HCV RNA was found in PBMC specimens of six (5.7 %) patients, from a total of 106 patients with undetectable plasma HCV RNA and anti-HCV Abs. Therefore, six out of 106 patients had OCI. HCV genotyping revealed that three patients were infected with HCV subtype 1b, two patients were infected with HCV subtype 3a, and one patient was infected with HCV subtype 1a. These results revealed that Iranian patients with beta-thalassemia major might have OCI. Therefore, it seems that the design of a study to identify this infection in patients with β-thalassemia major would provide valuable information.
隐匿性丙型肝炎病毒感染（OCI）是慢性肝炎病毒（HCV）感染的一种新的病理形式，其特征为肝活检和/或外周血单个核细胞（PBMC）标本中存在HCV RNA，而血浆样本中不存在HCV RNA和抗HCV抗体（Abs）。重型β地中海贫血是一种遗传性隐性血液疾病，其血红蛋白β链缺乏。地中海贫血患者需要输血治疗；反复输血会增加病毒血源性感染的风险。本研究的目的是确定伊朗重型β地中海贫血患者中OCI的患病率。2015年2月至2015年11月，共有147例伊朗重型β地中海贫血患者纳入了这项横断面研究。从血浆和PBMC样本中提取病毒RNA后，使用来自5'-UTR的引物通过RT巢式PCR扩增标本中的HCV基因组RNA。使用RFLP分析检测阳性标本的HCV基因型。为了确认HCV基因型，扩增5'-UTR片段并克隆到pJET1.2/平端克隆载体中，然后进行测序。在147例患者中，106例（72.1%）抗HCV Abs和HCV RNA均为阴性。在106例血浆HCV RNA和抗HCV Abs检测不到的患者中，有6例（5.7%）患者的PBMC标本中发现了HCV RNA。因此，106例患者中有6例患有OCI。HCV基因分型显示，3例患者感染了HCV 1b亚型，2例患者感染了HCV 3a亚型，1例患者感染了HCV 1a亚型。这些结果表明，伊朗重型β地中海贫血患者可能患有OCI。因此，似乎设计一项研究来识别重型β地中海贫血患者中的这种感染将提供有价值的信息。
