Effects of iron chelating therapy and / or HBV-vaccination on beta-thalassemia major patients

ABSTRACT

Thalassemia is a genetic inherited blood disorder in which the body makes abnormal hemoglobin with excessive destruction of red blood cells, which leads to anemia. For many years, hepatitis B virus was a major problem for patients with thalassemia substantially contracted from blood transfusions. The development of effective vaccine has further reduced the magnitude of the problem of hepatitis B. Iron chelators are used to remove excess iron that accumulates due to repeated blood transfusion. To compare thalassemic patients either have or haven't HCV with healthy persons as regards biochemical indices taking in consideration effect of vaccination against HBV or not and using iron chelating therapy or not by the studied persons. A case control study in which 40 thalassemic, blood transfusion dependent patients were chosen randomly to act as a case group from thalassemic patients attending the VACSERA Company. The cases [40 patients] they were classified to patients having HCV, patients were HBV vaccinated, other non vaccinated, using iron chelating therapyor don't use it. Another 10 healthy and non thalassemic persons were chosen randomly among persons attending the same company as a control group to be matched with the case group. 50% of studied thalassemic patients had HCV seropositivity. Biochemical blood indices which were found to be significantly elevated among thalassemic patients than controls were ALT, AST, ALP, GGT and LDH enzymes in addition to serum iron, ferritin and globulin mostly in HBV non-vaccinated and iron chelating therapy non dependent patients while, other biochemical indices which were significantly decreased among thalassemic patients compared to controls included total cholesterol, total protein, albumin and albumin/globulin ratio mostly in HBV vaccinated and iron chelating non dependent patients. This study illustrated the effectiveness of iron chelators agentsand the importance of vaccination for reduction of morbidity and mortality