ICMR Virus Unit, Peerless Hospital & B. K. Roy Research Centre, Kolkata, India.
Department of Hematology, Peerless Hospital & B. K. Roy Research Centre, Kolkata, India.
Indian J Med Res. 2018 Jun;147(6):581-587. doi: 10.4103/ijmr.IJMR_127_16.
BACKGROUND & OBJECTIVES: Multiple transfusions in β-thalassaemia patients undergoing regular transfusion regimen are at a risk of developing transfusion transmitted infections, including hepatitis C virus (HCV). The present study was conducted to investigate the association of HCV viraemia and genotype with clinical parameters in HCV seroreactive β-thalassaemic individuals.
A total of 172 HCV seroreactive β-thalassaemic individuals aged between 2-35 yr with at least 25 units of blood transfusion were catagorized into four groups (2-12 yr, group 1; 13-19 yr, group 2; 20-29 yr, group 3; 30-35 yr, group 4). Aged matched control samples (n=87; β-thalassaemics without HCV infection) were also included. HCV RNA was detected by nested reverse transcriptase polymerase chain reaction (RT-PCR) based on 5' UTR of HCV genome, viral load was determined by real-time RT-PCR. Nested RT-PCR amplified partial core region was used for DNA sequencing. Liver function parameters [serum total bilirubin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] were also determined.
Of the 172 HCV seroreactive individuals, 59.30 per cent (n=102) were HCV RNA positive. HCV viral load ranged from 173 to 32.04×10 IU/ml; 87.65 per cent were infected with HCV genotype 3. Liver enzymes, such as ALT, AST and serum total bilirubin were significantly elevated in all age groups compared to control groups. Serum ferritin levels were found to be high in all individuals, but 16.27 per cent of HCV-infected individuals with >10,000 IU/ml viral load also showed high ferritin levels (>1500 μg/l) where the majority of them were infected with HCV genotype 3.
INTERPRETATION & CONCLUSIONS: HCV genotype 3 was the major circulating genotype among β-thalassaemia patients in this region. Our findings indicated an association between HCV replication and hepatic iron load and also highlighted the need for sensitive quantitative RT-PCR-based detection of HCV RNA in the high risk population.
β-地中海贫血患者在接受常规输血方案时多次输血有感染输血传播感染的风险，包括丙型肝炎病毒（HCV）。本研究旨在探讨 HCV 病毒血症和基因型与 HCV 血清反应性β-地中海贫血个体临床参数的关系。
共纳入 172 例年龄在 2-35 岁之间、至少接受过 25 个单位输血的 HCV 血清反应性β-地中海贫血个体，分为 4 组（2-12 岁组，第 1 组；13-19 岁组，第 2 组；20-29 岁组，第 3 组；30-35 岁组，第 4 组）。还纳入了年龄匹配的对照组样本（n=87；无 HCV 感染的β-地中海贫血患者）。采用巢式逆转录聚合酶链反应（RT-PCR）基于 HCV 基因组 5'UTR 检测 HCV RNA，采用实时 RT-PCR 测定病毒载量。巢式 RT-PCR 扩增的部分核心区用于 DNA 测序。还测定了肝功能参数[血清总胆红素、丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）]。
在 172 例 HCV 血清反应性个体中，59.30%（n=102）为 HCV RNA 阳性。HCV 病毒载量范围为 173-32.04×10 IU/ml；87.65%感染 HCV 基因型 3。与对照组相比，所有年龄组的肝酶如 ALT、AST 和血清总胆红素均显著升高。所有个体的血清铁蛋白水平均升高，但 16.27%的 HCV 感染个体病毒载量>10000 IU/ml 也显示出高铁蛋白水平（>1500μg/l），其中大多数感染 HCV 基因型 3。
HCV 基因型 3 是该地区β-地中海贫血患者的主要流行基因型。我们的研究结果表明 HCV 复制与肝铁负荷之间存在关联，并强调了在高危人群中需要基于敏感定量 RT-PCR 检测 HCV RNA。
