Skip to main content

Advertisement

SpringerLink
Log in

Occult HBV Infection in Multi Transfused Thalassemia Patients

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To determine the prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infection in multitransfused thalassemic patients, with an aim to further highlight the need for donor screening strategy with supplementary molecular diagnostic tools for high risk population.

Methods

The study was conducted in 174 thalassemic subjects from Thalassemia unit of Central Red Cross Blood Bank, Cuttack, Odisha, India. Sero molecular diagnosis was followed to detect antigen, antibody and DNA in the study subjects.

Results

Prevalence of antibody to Hepatitis C, HBsAg, Anti HBs and Anti HBc were found to be 3.4 %, 0.5 %, 30.4 % and 21.8 % respectively. HBV seropositivity increased with increase in number of transfusions. Anti HBc was 12 %, 26.8 % and 71.4 % in subjects who received <40, 40–80 and >80 units of transfusions respectively. HBV DNA was detected in 50 % (3/6) of subjects having anti HBc as the only marker (Occult HBV infection). More so, it was detected in 16.12 % (5/31) of cases who were sero positive for both Anti HBs and Anti HBc.

Conclusions

These results indicate that thalassemic subjects need detailed screening of transfusion products. Fifty percent of occult HBV infection is a major concern suggesting inclusion of viral DNA amplification test along with antigen/antibody detection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Behera S, Dixit D, Bulliyya G, Kar SK. Fat soluble antioxidant vitamins, iron overload and chronic malnutrition in B thalassemia major. Indian J Pediatr. 2013;81:207–4.

    Google Scholar 

  2. Bansal D, Totadri S. Common hematological disorders in children. Indian J Pediatr. 2014;81:42–50.

    Article  PubMed  Google Scholar 

  3. Khakhkhar V, Joshi PJ. HBsAg seropositivity among multitransfused thalassemic children. Indian J Pathol Microbiol. 2006;9:516–8.

    Google Scholar 

  4. Irshad M, Peter S. Spectrum of viral hepatitis in thalassemic children receivingmultiple blood transfusions. Indian J Gastroenterol. 2002;21:183–4.

    PubMed  Google Scholar 

  5. Vergiliis SD, Fiorelli G, Firgion S, Cornacchia G, Sanna G, Cossu P, et al. Chronic liver disease in transfusion dependent thalassaemia: hepatitis B virus marker studies. J Clin Pathol. 1980;33:949.

    Article  Google Scholar 

  6. Goodnough LT, Brecher ME, Kunter ML, AuBuchon JP. Review article on blood transfusion. N Engl J Med. 1999;340:438–47.

    Article  CAS  PubMed  Google Scholar 

  7. Mishra S, Chayani N, Sarangi G, Mallick B, Pati SB. Seroprevalence of anti-HCV antibody in and around Cuttack. Orissa Indian J Med Microbiol. 2002;20:40–1.

    CAS  Google Scholar 

  8. Balgir RS. Spectrum of hemoglobinopathies in the state of Orissa, India: a ten tears cohort study. JAPI. 2005;53:1021–6.

    CAS  PubMed  Google Scholar 

  9. Arankalle VA, Murhekar, Gandhe SS, Murhekar MV, Ramdasi AY, Padbidri, et al. Hepatitis B virus: predominance of genotype D in primitive tribes of the Andaman and Nicober island, India (1989–1999). J Gen Virol. 2003;84:1915–20.

    Article  CAS  PubMed  Google Scholar 

  10. Singh H, Pradhan M, Singh RL, Phadke S, Naik SR, Aggarwal R, et al. High frequency of hepatitis B virus infection in patients with [beta]-thalassemia receiving multiple transfusion. Vox Sang. 2003;84:292–9.

    Article  CAS  PubMed  Google Scholar 

  11. Shah N, Mishra A, Chauhan D, Vora C, Shah NR. Study on effectiveness of transfusion programme in thalassemia major patients receiving multiple blood transfusions at transfusion centre inWestern India. Asian Jr Transfus Sci. 2010;4:94–8.

    Article  Google Scholar 

  12. Oza T, Agarwal A, Dhruva G, Oza HV. A study of prevalence of HIV, HbsAg and HCV in thalassemia major children. NJIRM. 2012;3114–7.

  13. Bhavsar H, Patel K, Vegad M, Madan M, Pandey A, Asthana A, et al. Prevalence of HIV, hepatitis B and hepatitis C infection in thalassemia major patients in tertiary care hospital, Gujarat. NJIRM. 2011;2:47–51.

  14. Jaiswal SP, Chitnis DS, Jain AK, Inamber S, Porwal A, Jain SC. Prevalence of hepatitis viruses among multitransfused homogenous thalassaemia patients. Hepatol Res. 2001;19:247–53.

    Article  PubMed  Google Scholar 

  15. Chakravarti A, Verma V, Kumaria R, Dubey AP. Anti- HCV seropositivity among multiple transfused patients with beta thalassaemia. J Indian Med Asoc. 2005;103:64–6.

    CAS  Google Scholar 

  16. Mankad GP, Singh SP. Incidence of viral hepatitis in thalassemic patients as a consequence of multiple blood transfusions. Int J Sci Res Publ. 2013;3. 2013 Edition.

  17. Jain R, Perkins J, Jhonson ST, Desai P, Khatri A, Chudgar U, et al. A prospective study for prevalence and/or development of transfusion-transmitted infections in multiply transfused thalassemia major patients. Asian J Transfus Sci. 2012;6:151–4.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Ismail AM, Devkumar S, Anantharam R, Fletcher GJ, Subramani T, John GT, et al. Low frequency of occult hepatitis B infection in anti-HBc seropositive blood donors: experience from a tertiary care centre in south India. Blood Transfus. 2012;10:230–1.

    PubMed Central  PubMed  Google Scholar 

  19. Asim M, Ali R, Khan LA, Husain SA, Singla R, Kar P. Significance of anti-HBc screening of blood donors and its association with occult hepatitis B virus infection: implications for blood transfusion. Indian J Med Res. 2010;132:312–7.

    PubMed  Google Scholar 

  20. Panigrahi R, Biswas A, Datta S, Banerjee A, Chandra PK, Mahapatra PK, et al. Anti-hepatitis B core antigen testing with detection and characterization of occult hepatitis B virus by an in-house nucleic acid testing among blood donors in Behrampur, Ganjam. Orissa in southeastern India: implications for transfusion. Virol J. 2010;7:204.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Saravanan S, Madhavan V, Murugavel KG, Balakrishnan P, Solomon SS, Subashini D, et al. Occult hepatitis B virus infection in a cohort of liver disease patients with chronic hepatitis C: A significantassociation of HCV genotyping 1B in south India. J Gastroenterol Hepatol. 2013;2:692–5.

    Google Scholar 

  22. Agarwal N, Naik S, Aggarwal R, Singh H, Somani SK, Kini D, et al. Occult hepatitis B virus infection as a cause of cirrhosis of liver in a region with intermediate endemicity. Indian J Gastroenterol. 2003;22:127–31.

    PubMed  Google Scholar 

  23. Rai RR, Mathur A, Mathur D, Udawat HP, Nepalia S, Nijhawan S, et al. Prevalence of occult hepatitis B & C in HIV patients infected through sexual transmission. Trop Gastroenterol. 2007;28:19–23.

    PubMed  Google Scholar 

  24. Jain P, Nijhawan S. Occult hepatitis C virus infection is more common than hepatitis B infection in maintenance hemodialysis patients. World J Gastroenterol. 2008;14:2288–9.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Hoofnagle JH, Gerety RJ, Ly N, Barker LF. Antibody to hepatitis B core antigen: a sensitive indicator of hepatitis B virus replication. N Engl J Med. 1974;290:1336–40.

    Article  CAS  PubMed  Google Scholar 

  26. Sethi GR, Sharma S, Sudha S, Rishi RK. Immunogenicity of recombinant hepatitis B vaccine in thalassemic children. Indian Pediatr. 1999;36:498–501.

    CAS  PubMed  Google Scholar 

  27. Rodriguez C, Deshmukh M, Jacob T, Nukala R, Menon S, Mehta A. Significance of HBV DNA by PCR over serological markers of HBVin acute and chronic hepatitis. Ind J Med Microbiol. 2001;19:141–4.

    Google Scholar 

  28. Quint WG, De Brujin I, Kruining H, Heijtink RA. HBV DNA detection by gene amplification in acute hepatitis B. Hepatology. 1990;12:653–6.

    Article  CAS  PubMed  Google Scholar 

  29. Scully LJ, Sung H, Pennie R, Gill P. Detection of hepatitis B virus DNA in the serum of Canadian hepatitis B surface antigen negative anti HBc positive individuals, using the polymerase chain reaction. J Med Virol. 1994;44:293–47.

    Article  CAS  PubMed  Google Scholar 

  30. Aggarwal R, Ghoshal UC, Naik SR. Treatment of chronic hepatitis B with interferon-alpha: cost-effectiveness in developing countries. Natl Med J India. 2002;15:320–7.

    PubMed  Google Scholar 

  31. Borkent-Raven BA, Janssen MP, Van Der Poel CL, De Wit GA, Bonsel GJ, Van Hout BA. Cost-effectiveness of additional hepatitis B virus nucleic acid testing of individual donations or minipools of six donations in the Netherlands. Transfusion. 2009;49:311–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Authors are thankful to Medical officers of Central Red Cross Blood Bank, Cuttack for providing clinical assistance, to Indian Council of Medical Research for financial assistance.

Contributions

BD: Study design, manuscript correction and will act as guarantor for this paper; JS: Laboratory test, manuscript writing; SKK: Study design, manuscript correction; LD: Sample collection and Lab test.

Conflict of Interest

None.

Source of Funding

This study is funded by Indian Council of Medical Research, New Delhi.

Author information

Authors and Affiliations

  1. Clinical Division, Regional Medical Research Centre, (ICMR), Bhubaneswar, 751023, Orissa, India

    Jyotsna Sabat, Bhagirathi Dwibedi, Leera Dash & Shantanu Kumar Kar

Authors
  1. Jyotsna Sabat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bhagirathi Dwibedi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Leera Dash
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shantanu Kumar Kar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bhagirathi Dwibedi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sabat, J., Dwibedi, B., Dash, L. et al. Occult HBV Infection in Multi Transfused Thalassemia Patients. Indian J Pediatr 82, 240–244 (2015). https://doi.org/10.1007/s12098-014-1490-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-014-1490-8

Keywords

Search

Navigation