Résumé
Hepatitis B virus [HBV] is one of the main causes of hepatitis, cirrhosis and hepatocellular carcinoma, and vaccination by anti-HBs is the only reliable method for its prevention. Since blood transfusion is one of the most important transmission routes of this virus, blood recipients may always be at its exposure. Considering the importance of vaccination in multitransfused patients, we decided to evaluate HBsAb level in them. In this cross sectional study with simple sampling, 83 patients with major thalassemia, 5 with hemophilia, and 5 with fanconi anemia, having been referred to Hajar Hospital of Shahrekord to receive blood and blood products in the year 2003 were evaluated for their level of HBsAb. The level of HBsAb was measured with Diasorin kit [sensitivity=95%, specificity=98%]. Data were statistically analyzed with chi-square test. Thirty patients [28.5%] were nonimmune, 11 [12.5%] were partially immune, and 52 [59%] were immune. Eighty eight patients had previous history of hepatitis B vaccination. Out of those who had received the last vaccination within the last 5 years, 82% were immune [p<0.05] and out of those who had it earlier, only 35.7% were immune. Besed on the results of this study, determination of immune status in multitransfused patients and their immunization are important and revaccination after a 5-year lapse in patients is recommended
Résumé
Hypertransfusion therapy has increased the duration and quality of life in the patients with beta thalassemia major. However it could lead to chronic iron overload and viral hepatitis that induce complications such as glucose metabolism disorders. The aim of this study was to find the prevalence of glucose metabolism disorders among beta-thalassemicpatients and compare with matched normal control group. The case group consisted of 40 multitransfusedthalassemic patients [10-20 years old, F/M = 47.5%, 52.5%] and the control group consisted of 40 matched normal persons. OGTT [Oral Glucose tolerance Test: blood sugar response to oral load of 1.75 g/ kg glucose] was performed in all persons. We also determined desferal dosage, serum ferritin level and markers of viral hepatitis [including HbsAg-HCV Ab-SGOT, SGPT, ALK.P] in thalassemic patients . The prevalence of glucose metabolism disorders was higher in the thalassemic patients compared to the normal group [15% versus 0%, P=0.01]. Glucose metabolism disorders was not higher in patients with thalassemia and viral hepatitis than thalassemic patients without hepatitis [16.6% versus 8.8%, P > 0.05]. The high frequency of glucose metabolism disorders in thalassemic patients was related to serum ferritin level [P < 0.05]. Our data showed the role of iron overload in glucose metabolism disorders and requirement of periodic control of serum ferritin level in b-thalassemia major patients