TRANSFUSION TRANSMITTED VIRAL HEPATITIS B AND HEPATITIS C INFECTION STATUS AND ASSOCIATED RISK FACTORS IN MULTI TRANSFUSED CHILDREN WITH BETA THALASSEMIA

Abstract

Introduction: Hemoglobinopathies, including β-thalassemia, are frequent worldwide, particularly in South Gujarat, India. Regular blood transfusions, which are required to manage thalassemia, increase the risk of transfusion-transmitted infections (TTIs), specifically Hepatitis B (HBV) and Hepatitis C (HCV). This study will look at the frequency and stages of HBV and HCV infections in multi-transfused thalassemia children in South Gujarat.

Aim: To determine the proportion of transfusion-related HBV and HCV infections in multi-transfused thalassemia children, to evaluate the stages of Hepatitis B and Hepatitis C infection and to evaluate risk factors associated with transfusion transmitted HBV and HCV.

Materials and Methods: An observational, cross-sectional study was carried out at a tertiary care facility in South Gujarat from July 2019 to October 2020. Sixty-six pediatric patients aged one to fifteen years with thalassemia who had received at least two blood transfusions or more who were either admitted to pediatric wards for routine blood transfusions or attended the outpatient department for regular care in the previous year were included. Serological assays were used to assess Hepatitis B and C infections, and positive cases were confirmed using HbeAg, Anti-HBc antibody and HCV RNA PCR. Data were examined for correlations between infection rates and a variety of parameters.

Results: Of the 66 patients, 1.5% tested positive for HBV, while 9.1% tested positive for HCV. HBV positive patient did not have active viral replication on further testing. All HCV positive cases had undetectable virus levels. Higher transfusion frequency was strongly linked with higher Hepatitis B(p=0.017) and Hepatitis C prevalence (p=0.0001). Elevated blood ALT and ferritin levels were seen in HCV-positive patients, indicating that they are potential indicators for Hepatitis C infection.

Conclusion: The study found a low HBV prevalence but a significant HCV prevalence among multi-transfused thalassemia children. Frequent blood transfusions are a significant risk factor for Hepatitis B and Hepatitis C. Newer techniques for early detection of Hepatitis B and Hepatitis C virus are needed to prevent TTI’s. It is recommended to improve blood screening techniques and check serum ALT and ferritin levels on a regular basis. Larger, multi-centre investigations are needed to validate these findings and evaluate transfusion safety practices.