PROSPECTIVE EVALUATION OF HBV, HCV, HIV AND SYPHILIS PREVALENCE IN Β-THALASSEMIA MAJOR PATIENTS BEFORE AND AFTER BLOOD TRANSFUSIONS.
Main Article Content
Keywords
Transfusion transmitted infections (TTIs), β-thalassemia (major), Chemiluminescence Immunosorbents Assay (CLIA), Immunochromatography technique (ICT).
Abstract
Abstract
Patients with β-thalassemia (major) frequently require blood transfusions, which puts them at increased risk of transfusion-related infections (TTIs). The transfusion transmitted infections are HCV, HBV, HIV and Syphilis. The main victims of TTIs are β-thalassemia (major) patients because they require regular blood transfusions which are very necessary for the survival of patients. The major complications are HCV, HBV, HIV and Syphilis as their causative agents are transferred consciously or unconsciously to the recipients. To check the infection rates in β-thalassemia (major) patients before and after blood transfusion is the main objective of this study. The other objective is to check the reliability of Immunochromatography Technique (ICT) and Chemiluminescence Immunoassay (CLIA) in detecting these infections. A total of 421 β-thalassemia (major) patients were selected initially but 21 patients were reactive with HCV so they excluded from study. The remaining 400 β-thalassemia (major) patients were selected for the study. Blood samples were collected from patients before blood transfusion and then after 3 months of 1st transfusions and then 6 months of 2nd blood transfusions and results were analyzed. The serum/plasma was separated by centrifugation and stored in Ultra-low at -70°C until further processing. The results showed an increased in the prevalence of infections among patients over time. Initially, all β-thalassemia (major) patients were free of infections. After the three months of 1st blood transfusions 3.5% of infections were detected in β-thalassemia (major) patients using Immunochromatography Technique (ICT) and 4% detected using Chemiluminescence Immunoassay (CLIA). The prevalence of Hepatitis C was 3.5% which is greater than other TTIs. The overall infection rates were increased after 6 months of blood transfusions. The prevalence of HCV increased by 4% and Hepatitis B (HBV) 0.50%. HIV was detected only in case of ICT technique but the CLIA did not confirm it. The specific analysis of age indicated a high infections rate of Hepatitis C was found in 11-20 years age group compared to other age groups. These results indicated that transfusions transmitted infections were increased with multiple transfusions. The study concluded that β-thalassemia patients are at high risk of transmitted transfusion infections. Hepatitis C is more prevalent infections in β-thalassemia patients. Infection rates were increased from 4% to 4.5 with successive transfusions. Two techniques ICT and CLIA were used for the detection of TTIs. Both techniques were effective for detecting TTIs but CLIA is more reliable than ICT due to capturing weak positive infectious agents which were not detected with ICT.
Chi square analysis revealed that there is no significant association between blood transfusions with transmitted transfusion infections. Future studies should be focused on the development of more advance and sensitive techniques for the detection of transmitted transfusion infections in β-thalassemia patients. Proper infections control practices and awareness about thalassemia will be helpful to minimize the infections rates.
References
2. Bou-Fakhredin R, De Franceschi L, Motta I, Eid AA, Taher AT, Cappellini MD. Redox balance in β-thalassemia and sickle cell disease: a love and hate relationship. Antioxidants. 2022 ;11(5):967.
3. Mahmoud HQ, Mhana RS, Mohammed AA. Therapeutic options and management approach on thalassemia an overview. International Journal of Medical Science and Dental Health. 2024 ;10(01):17-28.
4. Patterson S, Singleton A, Branscomb J, Nsonwu V, Spratling R. Transfusion complications in thalassemia: patient knowledge and perspectives. Frontiers in medicine. 2022 ;9:772886.
5. Ali S, Mumtaz S, Shakir HA, Khan M, Tahir HM, Mumtaz S, Mughal TA, Hassan A, Kazmi SA, Sadia, Irfan M. Current status of beta‐thalassemia and its treatment strategies. Molecular genetics & genomic medicine. 2021;9(12):e1788.
6. Shafique F, Ali S, Almansouri T, Van Eeden F, Shafi N, Khalid M, Khawaja S, Andleeb S. Thalassemia, a human blood disorder. Brazilian Journal of Biology. 2021 ;83:e246062.
7. Tzounakas VL, Anastasiadi AT, Stefanoni D, Cendali F, Bertolone L, Gamboni F, Dzieciatkowska M, Rousakis P, Vergaki A, Soulakis V, Tsitsilonis OE. Beta thalassemia minor is a beneficial determinant of red blood cell storage lesion. Haematologica. 2021 ;107(1):112.
8. Tarım HŞ, Öz F. Thalassemia major and associated psychosocial problems: a narrative review. Iranian Journal of Public Health. 2022 ;51(1):12.
9. Kiani AA, Mohamadinejad M, Shokrgozar N, Abbasian S. Mutations in Thalassemia Carrier Couples: The Importance of Prenatal Diagnostic Tests. Clinical Laboratory. 2022 ;68(5).
10. Teawtrakul N, Songdej D, Hantaweepant C, Tantiworawit A, Lauhasurayotin S, Torcharus K, Sripornsawan P, Sutcharitchan P, Surapolchai P, Komvilaisak P, Saengboon S. Red blood cell alloimmunization and other transfusion‐related complications in patients with transfusion‐dependent thalassemia: a multi‐center study in Thailand. Transfusion. 2022 ;62(10):2039-47.
11. Waheed U, Saba N, Wazeer A, Ahmed S. A systematic review and meta-analysis on the epidemiology of hepatitis B and hepatitis C virus among beta-thalassemia major patients in Pakistan. Journal of Laboratory Physicians. 2021 ;13(03):270-6.
12. Ali G, Tariq MA, Shahid K, Ahmad FJ, Akram J. Advances in genome editing: The technology of choice for precise and efficient β-thalassemia treatment. Gene therapy. 2021;28(1):6-15.
13. Lal A, Wong T, Keel S, Pagano M, Chung J, Kamdar A, Rao L, Ikeda A, Puthenveetil G, Shah S, Yu J. The transfusion management of beta thalassemia in the United States. Transfusion. 2021 ;61(10):3027.
14. Riaz M, Abbas M, Rasool G, Baig IS, Mahmood Z, Munir N, Mahmood Tahir I, Ali Shah SM, Akram M. Prevalence of transfusion-transmitted infections in multiple blood transfusion-dependent thalassemic patients in Asia: A systemic review. International Journal of Immunopathology and Pharmacology. 2022 ;36:03946320221096909.
15. Waqas M, Bashir R, andMuhammad Arshad KM. Unraveling Renal Complexities in Thalassemia Major: A Comprehensive Nephrological Inquiry in Central Punjab, Pakistan. Proc. Pakistan Congr. Zool. 2024;42:45-50.
16. Ding J, Huang Z, Jiang X, Li Q, Cao Y, Guo Y. The prevalence and genetic disorders spectrum of thalassemia among breast cancer patients in Jiangxi province, China. Frontiers in Genetics. 2022 ;13:1001369.
17. Batool T, Nawab S, Mehmood B, Younas NS, Khan MI, Nadeem K. The Analysis of Transfusion Transmitted Infections (TTIs) in Thalassemia Patients. Pakistan Journal of Medical & Health Sciences. 2022 ;16(02):269-.
18. Nasimzadeh S, Azaran A, Jalilian S, Makvandi M, Seyedian SS, Keikhaei B, Mehr FJ. Prevalence of occult hepatitis C virus infection in beta-thalassemia major patients in Ahvaz, Iran. Archives of Virology. 2021;166:2703-10.
19. Faranoush M, Faranoush P, Heydari I, Foroughi‐Gilvaee MR, Azarkeivan A, Parsai Kia A, Sadighnia N, Elahinia A, Zandi A, Rezvany MR, Hashemi‐Madani N. Complications in patients with transfusion dependent thalassemia: A descriptive cross‐sectional study. Health Science Reports. 2023 ;6(10):e1624.
20. Meloni A, Righi R, Missere M, Renne S, Schicchi N, Gamberini MR, Cuccia L, Lisi R, Spasiano A, Roberti MG, Zuccarelli A. Biventricular reference values by body surface area, age, and gender in a large cohort of well‐treated thalassemia major patients without heart damage using a multiparametric CMR approach. Journal of Magnetic Resonance Imaging. 2021 ;53(1):61-70.
21. Koochakzadeh L, Kajiyazdi M, Khoshhal F, Hashemi A, Khabazkhoob M. Prevalence of alloantibodies in thalassemia patients and its relationship with age, gender and blood group. Acta Medica Iranica. 2023:52-6.
22. Naeem U, Baseer N, Khan MT, Hassan M, Haris M, Yousafzai YM. Effects of transfusion of stored blood in patients with transfusion-dependent thalassemia. American Journal of Blood Research. 2021;11(6):592.
23. Biswas B, Naskar NN, Basu K, Dasgupta A, Basu R, Paul B. Transfusion-transmitted infections, its risk factors and impact on quality of life: An epidemiological study among β-thalassemia major children. Asian Journal of Transfusion Science. 2022 ;16(1):99-105.
24. Ghafoor MB, Memon FA, Saleem M, Shabbir R. Transfusion Transmitted Infections in Multiple Transfused Thalassemia Patients in Rahim Yar Khan. Journal of Liaquat University of Medical & Health Sciences. 2021;20(01):31-6.
25. Mirzaei G, Shamsasenjan K, Jafari B, Bagherizadeh Y, Sadafzadeh A, Bannazadeh-Baghi H, Sadeghi-Deylamdeh Z, Jafari-Sales A. Prevalence of HBV and HCV infection in beta-thalassemia major patients of Tabriz city, Iran. New Microbes and New Infections. 2021 ;43:100912.
26. Farshadpour F, Taherkhani R, Farajzadeh H. Hepatitis B infection among β-thalassemia major patients in Bushehr province of southern Iran. Journal of Immunoassay and Immunochemistry. 2023;44(2):147-61.
27. Talha M, Ali MH, Hurjkaliani S, Rahmat ZS, Sadia H, Al Hasibuzzaman M, Uzair AU. Beyond blood transfusions: exploring iron chelation therapies in transfusion-dependent beta-thalassemia. Annals of Medicine and Surgery. 2024:10-97.
28. Afreen H, Sheikh M, Jamal DE, Butt HO, Wadood M, Ali A. Assessment of the Infectious Status of Transmissible Transfusion Infections (Hepatitis B and C) among β-Thalassemia Major Patients of Karachi; A Multicenter Study by SBTA (Sindh Blood Transfusion Authority). Pakistan Journal of Medical & Health Sciences. 2023 ;17(01):675-.
29. Syed FN, Kashif N, Khan MR, Memon FA, Jabbar MZ, Palleti SK. Hepatitis C Virus Infection in Patients with Beta Thalassemia after Multiple Transfusions at a Tertiary Care Hospital. Pakistan Journal of Medical & Health Sciences. 2023 ;17(1):363-.
30. Azizi V, Abesi F, Tamaddoni A, Khafri S. Complications of patients with thalassemia major and intermedia in a selected Iranian population. Caspian journal of internal medicine. 2022;13(4):765.
31. Ghafoor M, Sabar MF, Sabir F. Prevention programmes and prenatal diagnosis for beta thalassemia in Pakistan: A narrative review. Journal of Pakistan Medical Association. 2021 ;71(1):326-.
32. Atmakusuma TD, Nasution IR, Sutandyo N. Oxidative stress (malondialdehyde) in adults beta-thalassemia major and intermedia: comparison between before and after blood transfusion and its correlation with iron overload. International Journal of General Medicine. 2021 :6455-62.
33. Wanchaitanawong W, Tantiworawit A, Piriyakhuntorn P, Rattanathammethee T, Hantrakool S, Chai-Adisaksopha C, Rattarittamrong E, Norasetthada L, Niprapan P, Fanhchaksai K, Charoenkwan P. The association between pre-transfusion hemoglobin levels and thalassemia complications. Hematology. 2021 ;26(1):1-8.
34. Cappellini MD, Glassberg MB, Meyers J, Jimenez M, Nham T, Bueno L, Sieluk J, Yucel A, Alashkar F. Demographics, clinical characteristics, and real-world treatment patterns among patients with beta-thalassemia: a retrospective medical record abstraction study. Therapeutic Advances in Hematology. 2024 ;15:20406207241298088.
35. Naz R, Ullah F, Muhammad T, Khan O, Shah F, u Rehman A, Basir NU. Incidence of Hepatitis B Due to Multiple Transfusions in Patients of β-Thalassemia Major: Incidence of Hepatitis B in Patients of β-Thalassemia Major. Pakistan Journal of Health Sciences. 2023 :86-90.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Shahzaib Haider
Department of Allied Health Sciences, Riphah International University Faisalabad
Amna Kausar
College of Allied Health Professionals, GC University Faisalabad
Aneesa Murtaza
Department of Biology (Microbiology), Lahore Garrison University
Ayesha Kanwal
Department of Biology (Microbiology), Lahore Garrison University
Muhammad Jabran
Department of Allied Health Sciences, Riphah International university Faisalabad
Faika Arooj
Allied Health Professionals, Riphah International university, Lahore
Zunaira Saleem
Allied Health professionals, Riphah International university, Lahore
Hafiz Asif Muhammad Ali
Department: Department of Biology (Microbiology), Lahore Garrison University