Farooq Ahmad, Waheed Usman, Saba Noore, Kaleem Muhammad, Majeed Najma, Wazeer Akhlaaq, Cheema Naila Arif, Ahmed Saeed, Arshad Muhammad
Department of Biological Sciences, International Islamic University, Islamabad, Pakistan.
Department of Pathology and Transfusion Medicine, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.
J Family Med Prim Care. 2021 Feb;10(2):998-1002. doi: 10.4103/jfmpc.jfmpc_1880_20. Epub 2021 Feb 27.
Hepatitis B virus (HBV) is the aetiological agent of transfusion-transmitted hepatitis globally. Beta thalassaemia major individuals are at greater risk of contracting HBV infection due to multiple blood transfusions required for the medical management of these patients. Based on HBV genetic variability, it is divided into 10 genotypes. The determination of HBV genotypes has significant implications for clinical management and treatment regimens.
This study was performed to assess the HBV epidemiology and circulating genotypes in multi-transfused β-thalassemia major patients with the aim to be considered while formulating the treatment pattern taking into account particular needs of thalassaemia patients.
This study was performed from September 2018 to June 2019, at the Department of Pathology and Transfusion Medicine, Shaheed Zulfiqar Ali Bhutto (SZAB) Medical University, Islamabad. A total of 2,260 thalassaemia patients were enrolled in the study. The study was endorsed by the Ethics Committee of the SZAB Medical University, Islamabad. The samples were serologically screened for HBsAg on the LIAISON® XL Murex HBsAg Quant assay (DiaSorin S.p.A., Italy) a chemiluminescence based immunoassay (CLIA). HBV quantitative PCR kit was used to measure the HBV DNA in serum samples. The HBV genotypes were determined using universal primers targeting the P1 and S1 region amplification.
Of 2,260 thalassaemia patients, 64.6% were males while 35.4% were females. The HBsAg was identified in 98 individuals (4.33%). The PCR analysis was done for these 98 patients and in this cohort, genotype D was 59.18% ( = 58), genotype A was 21.42% ( = 21) while genotype C was 19.38% ( = 19).
The determination of HBV genotypes in the multi-transfused patients is key to the effective management of chronic HBV patients as the severity and course of the disease is dependent on a specific type of genotypes. Quality assured screening of donated blood will prevent the incidence of HBV in thalassaemia patients.
乙型肝炎病毒（HBV）是全球输血传播性肝炎的病原体。重型β地中海贫血患者由于疾病治疗需要多次输血，感染HBV的风险更高。基于HBV基因变异性，其被分为10个基因型。HBV基因型的确定对临床管理和治疗方案具有重要意义。
本研究旨在评估多次输血的重型β地中海贫血患者中的HBV流行病学及流行基因型，以便在制定治疗方案时考虑地中海贫血患者的特殊需求。
本研究于2018年9月至2019年6月在伊斯兰堡沙希德·祖尔菲卡尔·阿里·布托（SZAB）医科大学病理学与输血医学系进行。共有2260例地中海贫血患者纳入本研究。本研究获得了伊斯兰堡SZAB医科大学伦理委员会的批准。采用基于化学发光免疫分析（CLIA）的LIAISON® XL Murex HBsAg定量检测法（意大利DiaSorin S.p.A.公司）对样本进行HBsAg血清学筛查。使用HBV定量PCR试剂盒检测血清样本中的HBV DNA。采用靶向P1和S1区域扩增的通用引物确定HBV基因型。
2260例地中海贫血患者中，男性占64.6%，女性占35.4%。98例（4.33%）患者检测出HBsAg阳性。对这98例患者进行了PCR分析，该队列中，D基因型占59.18%（n = 58），A基因型占21.42%（n = 21），C基因型占19.38%（n = 19）。
确定多次输血患者的HBV基因型是有效管理慢性HBV患者的关键，因为疾病的严重程度和病程取决于特定的基因型类型。确保献血质量的筛查将预防地中海贫血患者中HBV的发生。
