Dumaidi Kamal, Al-Jawabreh Amer, Samarah Fekri, Rabayaa Maha
Department of Medical Lab Sciences, Arab American University, Palestine, State of Palestine.
Al-Quds Public Health Society, Jerusalem, State of Palestine.
Can J Infect Dis Med Microbiol. 2018 Sep 5;2018:1039423. doi: 10.1155/2018/1039423. eCollection 2018.
HCV and HBV present a great challenge in the management of -thalassemia patients.
The present study aimed to determine the prevalence of both HBV and HCV in multitransfused-dependent -thalassemia patients in northern West Bank, Palestine, using sero-molecular markers.
Serum sample from 139 multitransfused -thalassemia patients were tested for HBV and HCV markers including HBsAg, anti-HBc, anti-HBs, HBV-DNA, and anti-HCV and HCV-RNA. Demographic data and selected clinical parameters were collected by means of a questionnaire and from the patients' medical files.
The mean (±SD) age of patients was 18.1 years (±10.6). The overall prevalence of the HCV was 10% (14/139), which is 50 times higher than the normal Palestinian population (0.2%). Of which, 3 were positive for anti-HCV alone, 7 positives for HCV-RNA alone, and 4 positives for both anti-HCV and PCR-RNA. On the other hand, low prevalence of HBV was detected at a level of 0.7% (1/139). Only one patient had HCV-HBV coinfection. Twenty-five patients (19%) were positive for anti-HBc, while 99 (71%) were immune with the anti-HBs level above 10 IU/mL. Anti-HBc was insignificantly high (=0.07) in HCV-positive cases. In conclusion, the prevalence of HCV among -thalassemia patients is considered high compared to normal population. Determination of HCV prevalence should be based on the detection of both HCV-RNA and anti-HCV. On the contrary, HBV showed a low prevalence. A follow-up schedule and administration of booster dose of HBV vaccine is strongly recommended for -thalassemia patients whose anti-HBs level <10 IU/ml.
丙型肝炎病毒(HCV)和乙型肝炎病毒(HBV)给地中海贫血患者的管理带来了巨大挑战。
本研究旨在使用血清分子标志物确定巴勒斯坦约旦河西岸北部多次输血依赖型地中海贫血患者中HBV和HCV的流行率。
对139例多次输血的地中海贫血患者的血清样本进行HBV和HCV标志物检测,包括乙肝表面抗原(HBsAg)、乙肝核心抗体(抗-HBc)、乙肝表面抗体(抗-HBs)、乙肝病毒DNA(HBV-DNA)、丙肝抗体(抗-HCV)和丙肝病毒RNA(HCV-RNA)。通过问卷调查和患者病历收集人口统计学数据和选定的临床参数。
患者的平均(±标准差)年龄为18.1岁(±10.6)。HCV的总体流行率为10%(14/139),比正常巴勒斯坦人群(0.2%)高50倍。其中,3例仅抗-HCV阳性,7例仅HCV-RNA阳性,4例抗-HCV和PCR-RNA均阳性。另一方面,检测到HBV的低流行率为0.7%(1/139)。仅1例患者为HCV-HBV合并感染。25例患者(19%)抗-HBc阳性,而99例(71%)抗-HBs水平高于10 IU/mL具有免疫力。HCV阳性病例中抗-HBc略高(P=0.07)。总之,与正常人群相比,地中海贫血患者中HCV的流行率较高。HCV流行率的测定应基于HCV-RNA和抗-HCV的检测。相反,HBV显示出低流行率。强烈建议对那些抗-HBs水平<10 IU/ml的地中海贫血患者进行随访并接种乙肝疫苗加强针。