RESUMEN
Hepatitis C virus is a major health care problem in Egypt. One of its high risk groups are multi-transfused children suffering from chronic hemolytic anemia. In the current study we aimed to investigate the prevalence of hepatitis C virus status [HCV] in thalassemia major and sickle cell anemia patients who are regularly following at the pediatric hematology clinics, Cairo University. We also aimed to compare the current prevalence with previous studies conducted before the introduction of donor screening for HCV and so determine the effectiveness of screening currently in use. Two hundred and eighteen children were enrolled in the study. Most of them were thalassemia cases [n=168], while fifty were sickle cell disease patients. The study also included twenty healthy age- matched control to determine the base line risk in the general population. All patients and controls were investigated for the presence of HCV antibody using fourth generation ELISA techniques. The results showed that the over all HCV sero-prevalence rate was 40.5% in thalassemia patients and 50% in sickle cell disease patients, a much lower rate than previously reported before the era of donor screening. The risk for HCV infection in both thalassemia and sickle cell anemia increased with increased duration of transfusion. The mean transfusion duration in HCV positive thalassemia patients was [10.28 +/- 6 years] while among sero-negatives it was [3.27 +/- 4.32 years]. In sickle cell anemia group, the mean duration of transfusion was [7.04 +/- 4.29 y] among HCV positives versus [3.38 +/- 3 y] among HCV negatives and the relation was also highly significant. Serum ferritin was a significantly elevated in HCV positive cases both in sickle and thalassemia patients. The frequency of HCV infection has moderately declined since the introduction of blood screening techniques, however the current prevalence is still high and more efforts are needed to introduce new techniques that avoid the window gap and increase the sensitivity of used techniques. The duration of blood transfusion and high levels of serum ferritin were identified as possible risk factors for HCV infection in the studied groups