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Prevalence and Clinical Significance of Hepatitis C Virus Infection in Thai Patients with Thalassemia

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Abstract

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.

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Authors and Affiliations

  1. Division of Hematology and WHO Collaborating Centre for the Control of Haemoglobinopathies, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700, Bangkok, Thailand

    Wanchai Wanachiwanawin

  2. Gastroenterology, Department of Medicine, Mahidol University, Bangkok, Thailand

    Pairoj Luengrojanakul

  3. Department of Clinical Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University Bangkok, Thailand

    Wattana Leowattana

  4. Institute of Science and Technology, Mahidol University, Bangkok, Thailand

    Pornpan Sirangkapracha & Suthat Fucharoen

Authors
  1. Wanchai Wanachiwanawin
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  2. Pairoj Luengrojanakul
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  3. Pornpan Sirangkapracha
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  4. Wattana Leowattana
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  5. Suthat Fucharoen
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Correspondence to Wanchai Wanachiwanawin.

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Wanachiwanawin, W., Luengrojanakul, P., Sirangkapracha, P. et al. Prevalence and Clinical Significance of Hepatitis C Virus Infection in Thai Patients with Thalassemia. Int J Hematol 78, 374–378 (2003). https://doi.org/10.1007/BF02983565

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  • DOI: https://doi.org/10.1007/BF02983565

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