Analysis of the related factors in hepatitis C virus infection among hemophilic patients in Isfahan, Iran

Patients with hemophilia are at high risk of post-transfusion hepatitis because of widespread use of plasma-derived products. As a consequence, hepatitis C virus [HCV] is the most common cause of chronic liver disease among hemophilic patients. The objectives of this study are to determine HCV prevalence, and analyze the effective agents in HCV infection in hemophilic patients. All patients with inherited coagulation disorders registered in hemophilia center of Isfahan [553 persons] were checked for HBsAg and anti-HCV, using enzyme-linked immunosorbent assay [ELISA] test. Positive tests for anti-HCV were confirmed by RT-PCR. Clinical history, laboratory and treatment data of all cases were studied in January 2006. From 465 men and 88 women with inherited coagulation disorders with the mean age of 23.4 +/- 12.9 years, 125 patients [22.6%] were HCV positive, 2 [0.4%] were HBV positive and one [0.2%] was both HCV and HBV positive. Odds ratio between HCV infection and cryoprecipitate usage was 3 [CI 95%: 2-4.5] and between HCV and factor usage was 0.21 [CI 95%: 0.07-0.7]. Considering the high chance of HCV infection after transfusion of cryoprecipitate and, a more careful pre-transfusion screening of blood for anti-HCV must be introduced in all blood banks. The usage of FFP less chance of HCV infection, instead of cryoprecipitate in patients who do not have volume restrictions may be preferable

[Relationship between pancreas echogenisity and insulin sensitivity during the course of OGTT in children with beta-thalassemia major aged 10-20 years]

Background: increased echogenicity of pancreas, due to hemosiderosis, is a frequent finding in beta thalassemic paitents. Hemosiderosis also leads to beta - cell dysfunction. So diabetes and glucose intolerance are common consequences of hemosiderosis. The aim of this study was to investigate the association of increased pancreas. echogenicity [IPE] with insulin sensitivity in beta - thalassemic children aged 10-20 years

Methods: after exclusion of thalassemic paitents with diabetes or familial history of diabetes, pancreas ultrasonography was performed in 42 beta-thalassemic children and they were divided into 2 groups with normal [21] and increased [21] pancreas echogenicity. Serum ferritin was measured, as well as serum insulin and glucose values, during an OGTT, at 0, 30, 60 and 120 minutes. A control group was selected randomly [n= 23]. Insulin Sensitivity Index and Fasting Glucose/Insulin Ratio were calculated and the data were analysed using t-test and ANOVA statistical methods

Results: serum feritin differed significantly between 2 groups of thalassemic paitents [P<0.005], but the insulin and glucose values were not significantly different among studied population [P>0.05]. Serum feritin was inversely correllated with ISI in patients IPE and 28.6% of them had IFG, as compared to patients with normal echogenicity [P<0.05]

Conclusion: regarding the detection of all IFG cases among thalassemic paitents with IPE and the relation of feritin with IS1 in this group, pancreas ultrasonography may be used to investigate the early stages of diabetes in these patients. however after conducting further studies with larger sample size and on older paitents are recommended