Sultan S, Irfan S M, Siddiqui M, Zaidi S M H
Liaquat National Hospital and Medical College,Department of Haematology, Karachi, Pakistan.
Malays J Pathol. 2016 Dec;38(3):251-255.
Though regular blood transfusion improves the survival, it carries the unavoidable risk of transfusion transmitted infections (TTI) in β-thalassaemic patients. Owing to the lack of uniformity in blood screening practices in Pakistan, TTI is still a major challenge.
To study the current trends of TTI in regularly transfused β-thalassaemics and their correlation with age, number of transfusions, hematological and biochemical markers.
We carried out a prospective case-control study. 100 β-thalassemic patients and 200 healthy donors were recruited from June 2011 to June 2014. HCV antibodies, Hepatitis B surface antigen and human immunodeficiency virus antibodies (I & II) were evaluated. Complete blood counts, LFTs and serum ferritin were tested on all patients.
Mean age of patients and controls was 11.18±5.07 and 20.5±1.87 years respectively. In patients, 54% and 46% were males and females respectively. Anti-HCV antibody and HbsAg were positive in 27% versus 3% and 3% versus 2% in patients and controls respectively. None of the patients and controls was HIV reactive. Seropositivity of Anti-HCV was significantly higher in patients than that of controls (P<0.001). Anti-HCV positively correlated with age above 10 years, numbers of transfusions (≥150 units), high serum ferritin, elevated ALT and alkaline phosphatase (P<0.001).
Over the decade, TTI magnitude has significantly reduced, but hepatitis C is still a main hazard. Further preventive measures including nucleic acid testing, voluntary donation and stringent donor selection will be required for reducing TTI in β-thalassaemics.
尽管定期输血可提高生存率，但在β地中海贫血患者中，输血仍不可避免地存在传播输血相关感染（TTI）的风险。由于巴基斯坦血液筛查做法缺乏统一性，TTI仍然是一个重大挑战。
研究定期输血的β地中海贫血患者中TTI的当前趋势及其与年龄、输血量、血液学和生化指标的相关性。
我们进行了一项前瞻性病例对照研究。2011年6月至2014年6月招募了100例β地中海贫血患者和200名健康献血者。评估了丙型肝炎病毒抗体、乙型肝炎表面抗原和人类免疫缺陷病毒抗体（I和II）。对所有患者进行了全血细胞计数、肝功能检查和血清铁蛋白检测。
患者和对照组的平均年龄分别为11.18±5.07岁和20.5±1.87岁。患者中，男性和女性分别占54%和46%。患者和对照组中抗丙型肝炎病毒抗体和乙肝表面抗原阳性率分别为27%对3%和3%对2%。患者和对照组均无HIV反应性。患者中抗丙型肝炎病毒血清阳性率显著高于对照组（P<0.001）。抗丙型肝炎病毒与10岁以上年龄、输血量（≥150单位）、高血清铁蛋白、谷丙转氨酶升高和碱性磷酸酶升高呈正相关（P<0.001）。
在过去十年中，TTI的发生率已显著降低，但丙型肝炎仍然是主要危害。为降低β地中海贫血患者的TTI，需要采取进一步的预防措施，包括核酸检测、自愿献血和严格的献血者筛选。
