Serum alanine aminotransferase level among thalassemic children infected with hepatitis C virus

ABSTRACT

Hepatitis C virus is responsible for a majority of post-transfusion hepatitis in thalassemic patients. Serum aminotransferase level is a method to assess hepatitis C virus infected patients. To determine and correlate serum alanine aminotransferase level with hepatitis C virus specific antibody, RNA positivity and genotyping among children with thalassemia major. The study was performed on 269 patients with thalassemia major. All sera were tested for Hepatitis C virus specific antibody using third generation enzyme immunoassay EIA-3 Kit. Positive sera were retested using third generation immuno blot confirmatory test Lia-Tek-III Kit. RT-PCR and DNA enzyme immunoassay DIA were performed on 78 sera to determine HCV-RNA positivity with subsequent genotyping. All sera were submitted for serum Alanine Aminotransferase level measurement. Of the 269 thalassemic children. 18167.3% were positive for Hepatitis C virus specific antibody. No significant different in mean serum Alanine Aminotransferase level were seen between anti Hepatitis C virus sero-positive 15.43 +/- 19.89 IU/L and seronegative 11.23 +/- 13.79 IU/L children [t =1.79, p>0.05]. The mean serum Alanine Aminoiransferase level among HCV-RNA positive and HCV-RNA negative samples was 40.11 +/- 24.66 IU/L and 5.95 +/- 4.46 IU/L respectively showing a significant difference [t = 6.43. p=0.0001]. Three Hepatitis C virus genotypes were detected 1a, 1b and 4 with predominance of type 4. Significant difference in the mean of serum ALT level was demonstrated among various types of Hepatitis C virus especially among those with genotype 1b [F=11.74, p =0.0001]. No significant elevation in serum transaminase level among Hepatitis C virus seropositive children with thalassemia major compared with seronegative ones. There was a significant rise in serum transaminase level among HCV-RNA positive patients especially among those with genotype 1b