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.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
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.
Wanachiwanawin W. Infections in E-beta thalassemia.J Pediatr Hematol Oncol. 2000;22:581–587.
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.
Alter HJ, Parcell RH, Shih JW, et al. Detection of antibody to hepatitis C virus in prospectively followed transfusion recipients with acute and chronic non-A, non-B hepatitis.N Engl J Med. 1989;321:1494–1500.
Sarbah SA, Younossi ZM. Hepatitis C: an update on the silent epidemic.J Clin Gastroenterol. 2000;30:125–143.
Wonke B, Hoffbrand AV, Brown D, Dusheiko G. Antibody to hepatitis C virus in multiply transfused patients with thalassaemia major.J Clin Pathol. 1990;43:638–640.
Erer B, Angelucci E, Lucarelli G, et al. Hepatitis C virus infection in thalassemia patients undergoing allogeneic bone marrow transplantation.Bone Marrow Transplant. 1994;14:369–372.
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.
Alter HJ. To C or not to C: these are the questions.Blood. 1995;85:1681–1695.
Luengrojanakul P, Vareesangthip K, Chainuvatti T, et al. Hepatic C virus infection in patients with chronic liver disease or chronic renal failure and blood donors in Thailand.J Med Virol. 1994;44:287–292.
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.
Okamoto H, Tsuda F, Machida A, et al. Antibodies against synthetic oligopeptides deduced from the putative core gene for the diagnosis of hepatitis virus infection.Hepatology. 1992;15:180–186.
Iizuka H, Ohmura K, Ishijima A, et al. Correlation between anti-HBc titers and HBV DNA in blood units without detectable HBs Ag.Vox Sang. 1992;63:107–111.
International Committee for Standardization in Haematology (ICSH). The measurement of total and unsaturated iron-binding capacity in serum.Br J Haematol. 1978;38:281–287.
International Committee for Standardization in Haematology (ICSH). Recommendation for measurement of serum iron in human blood.Br J Haematol. 1978;38:291–294.
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.
Laosombat V, Pornpatkul M, Wongchanchailert M, Worachai K, Wiriyasatienku A. The prevalence of hepatitis C virus antibodies in thalassemic patients in the south of Thailand.Southeast Asian J Trop Med Public Health. 1997;28:149–153.
Poovorawan Y, Pongpunlert W, Chumdermpadetsuk S, Sakulramrung R, Israsena S. The prevalence of hepatitis C virus antibodies among high risk groups in Thailand.Southeast Asian J Trop Med Public Health. 1991;22:133–134.
Williams TN, Wonke B, Donohue SM. A study of hepatitis B and C prevalence and liver function in multiply transfused thalassemia and their parents.Indian Pediatr. 1992;29:1119–1124.
Khalifa AS, Mitchell BS,Watts DM, et al. Prevalence of hepatitis C viral antibody in transfused and nontransfused Egyptian children.Am J Trop Med Hyg. 1993;49:316–321.
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.
Borzini P, Cazzaniga G, Vecchi L. Prevalence of anti-hepatitis C virus seroconversion in polytransfused thalassemic patients.Vox Sang. 1991;60:188.
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.
Wasi P. Haemoglobinopathies including thalassaemia, part 1: tropical Asia.Clin Haematol. 1981;10:707–729.
About this article
Cite this article
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
- Hepatitis C
- Liver function
- Iron overload