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印度西部多次输血的地中海贫血患者中乙肝病毒、丙肝病毒和HIV-1的血清流行率及其与分子标志物的相关性

Seroprevalence of HBV, HCV and HIV-1 and Correlation with Molecular Markers among Multi-Transfused Thalassemia Patients in Western India.

作者信息

Mishra Kanchan, Shah Avani, Patel Krima, Ghosh Kanjaksha, Bharadva Sumit

机构信息

Surat Raktadan Kendra & Research Centre, 1.

Floor, Khatodara Health Centre, Near ChosathJoganiya Mata Mandir, UdhanaMagdalla Road, Khatodara - 394210, Surat (Gujarat), India.

出版信息

Mediterr J Hematol Infect Dis. 2020 Jul 1;12(1):e2020038. doi: 10.4084/MJHID.2020.038. eCollection 2020.

Abstract

BACKGROUND

Multitransfused β-thalassemia major patients are always at high risk of having Transfusion Transmitted Infections (TTIs). This study was aimed to determine the seroprevalence of HBsAg, Anti-HIV-1/2, and Anti-HCV among these patients and to correlate the same with NAT testing.

METHODS

A total of 196 patients with β-thalassemia were included in the study. Patients were screened for the presence of viral markers by third-generation ELISA test as well as for viral DNA/RNA by NAT test.

RESULTS

Among 196 multi-transfused Beta-thalassemia patients, the seroprevalence of anti-HCV was very high 100 (51.1%), however, anti-HIV1/2 was 6 (3.1%), and HBsAg were 3 (1.5%). Surprisingly similar patterns were observed in the prevalence of molecular markers, as HCV-RNA were 66 (33.7%) of the patients along with HIV-1 RNA were 8 (4.1%), and HBV-DNA were 5 (2.5%) patients. Overall eight (4.1%) patients were found to have coinfections, where two were positive for HBsAg/anti-HCV by ELISA along with 3 (1.5%) were positive for HBV-DNA/ HCV-RNA, 1 (0.5%) was positive for HIV-RNA/HBV-DNA, and 2 (1%) had coinfection of HIV-RNA/ HCV RNA by NAT testing.

CONCLUSION

The prevalence of HCV infection among multi-transfused β-thalassemia patients is significantly higher than that of the HBV and HIV infections. This scenario should be controlled and monitored by doing regular follow-up testing schedules of such patients and also the administration of the booster dose of the HBV vaccine along with HCV treatment with antiviral DAAs.

摘要

背景

多次输血的重型β地中海贫血患者始终面临输血传播感染(TTIs)的高风险。本研究旨在确定这些患者中HBsAg、抗HIV-1/2和抗HCV的血清流行率,并将其与核酸检测(NAT)结果相关联。

方法

本研究共纳入196例β地中海贫血患者。通过第三代酶联免疫吸附试验(ELISA)对患者进行病毒标志物筛查,并通过核酸检测(NAT)检测病毒DNA/RNA。

结果

在196例多次输血的β地中海贫血患者中,抗HCV的血清流行率非常高,为100例(51.1%),而抗HIV1/2为6例(3.1%),HBsAg为3例(1.5%)。在分子标志物的流行率方面观察到了惊人的相似模式,丙肝病毒RNA(HCV-RNA)阳性患者为66例(33.7%),人类免疫缺陷病毒1型RNA(HIV-1 RNA)阳性患者为8例(4.1%),乙肝病毒DNA(HBV-DNA)阳性患者为5例(2.5%)。总体而言,发现8例(4.1%)患者存在合并感染,其中2例ELISA检测HBsAg/抗HCV呈阳性,3例(1.5%)HBV-DNA/HCV-RNA呈阳性,1例(0.5%)HIV-RNA/HBV-DNA呈阳性,2例(1%)核酸检测(NAT)显示HIV-RNA/HCV RNA合并感染。

结论

多次输血的β地中海贫血患者中HCV感染的流行率显著高于HBV和HIV感染。应通过对此类患者进行定期随访检测计划以及接种乙肝疫苗加强针并使用抗病毒直接作用抗病毒药物(DAAs)治疗HCV来控制和监测这种情况。

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