Prevalence and Clinical Significance of Hepatitis C Virus Infection in Thai Patients with Thalassemia
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Hepatitis C virus (HCV) infection is a common cause of liver disease in thalassemia major patients in Western, especially Mediterranean, countries. Its significance in thalassemic patients from Southeast Asia has not been critically evaluated. In this report, we describe our study of the prevalence of HCV infection among Thai patients with thalassemia. The relationships of the infection to blood transfusion and the infection’s effects on liver function have also been determined. Of the 104 patients studied, 21 (20.2%) tested positively by enzyme immunoassay for anti-HCV antibody, whereas only 2 patients (2%) had the hepatitis B surface antigen. There was no significant relationship between the presence of anti-HCV antibodies and the number and frequency of blood transfusions. In fact, 2 patients (10%) who tested positive for anti-HCV antibodies had never received transfusions. Patients with anti-HCV antibodies had significantly abnormal liver functions, such as higher levels of serum aspartate aminotransferase (SGOT) and alanine aminotransferase (SGPT) and lower levels of serum albumin, compared with patients without anti-HCV antibodies (P = .021, .017, and .004, respectively). However, there were also significant correlations between iron status as indicated by transferrin saturation or serum ferritin levels and SGOT, SGPT, and γ-glutamyltransferase (GGT) levels. Moreover, abnormal liver function as represented by elevated levels of SGOT, SGPT, GGT, and serum alkaline phosphatase was observed more frequently in patients with iron overload than in patients with a lower degree of iron burden. The presence of HCV did not alter the effects of iron overload on liver function. The findings suggest that both HCV and iron overload are the main causes of abnormal liver function in Thai patients with thalassemia. The treatment of both problems, if coexisting in patients with thalassemia, is required to prevent progression to chronic liver disease.
Key wordsThalassemia Hepatitis C Liver function Iron overload
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- 1.Issaragrisil S, Wanachiwanawin W, Bhuripanyo K, Benjasuratwong Y, Piankijagum A, Wasi P. Infection in thalassemia: a retrospective study of 1,018 patients with β-thalassemia/Hb E.Birth Defects Orig Artic Ser. 1988;23:505–511.Google Scholar
- 3.Fucharoen S, Piankijagum A, Wasi P. Deaths in β-thalassemia/Hb E patients secondary to infections.Birth Defects Orig Artic Ser. 1988;23:495–500.Google Scholar
- 8.Lai ME, De Virgilis S, Argiolu F, et al. Evaluation of antibodies to hepatitis C virus in long-term prospective study of posttransfusion hepatitis among thalassemic children: comparison between firstand second-generation assay.J Pediatr Gastroenterol Nutr. 1993;16:458–464.CrossRefPubMedGoogle Scholar
- 11.Nagayama R, Miyake K, Tsuda F, Okamoto H. IgM antibody to a hepatitis C virus core peptide (CP 14) for monitoring activity of liver disease in patients with acute or chronic hepatitis C.J MedVirol. 1994;42:311–317.Google Scholar
- 16.Cook JD, Dallman PR, Bothwell TH, et al. Serum ferritin: measurement of iron status. A report of the International Nutritional Anemia Consultative Group (INACG). Kansas, USA: International Nutritional Anemia Consultative Group (INACG); 1985:35–54.Google Scholar
- 21.Bejachandra S, Chongholwatana V, Panchavinnin W, et al. Serological infections disease markers in blood donated at Siriraj Hospital.Siriraj Hosp Gaz. 1998;50:16–27.Google Scholar
- 23.Jamal R, Fadzillah G, Zulkifli SZ, Yasmin M. Seroprevalence of hepatitis B, hepatitis C, CMV and HIV in multiply transfused thalassemia patients: results from a thalassemia day care center in Malaysia.Southeast Asian J Top Med Public Health. 1998;29:792–794.Google Scholar
- 24.Wasi P. Haemoglobinopathies including thalassaemia, part 1: tropical Asia.Clin Haematol. 1981;10:707–729.Google Scholar