Prevalence of Transfusion Transmitted Infections in Multiple Blood Transfused β-Thalassemia Patients from a Tertiary Care Centre in North India

ABSTRACT

Introduction: The mainstay of therapy for patients sufferingfrom beta thalassemia major is regular blood transfusionand chelation therapy due to constraints in bone marrowtransplantation. The present study was conducted to estimatethe prevalence of transfusion-transmitted infections (TTIs)in multitransfused patients of thalassemia major and todetermine the association with relation to the number of bloodtransfusions received.Material and Methods: This study was conducted inDepartment of Microbiology on 126 β- thalassemiamajor patients registered for regular blood transfusions atThalassemia Day Care Centre attached to Department ofPediatrics, Government Medical College, Amritsar, Punjabfrom January to July 2018. The patient’s serum sampleswere screened for TTIs i.e. Human Immunodeficiency Virus(HIV), Hepatitis B virus (HBV) and Hepatitis C virus (HCV).Seropositivity screening for HBV and HCV was done by rapidImmunochromatographic test and confirmed by enzymelinked immunosorbent assays. (ELISA) while for HIV as perNACO guidelines.Results: Out of 126 patients, 14.28% (18/126) were seroreactive for TTIs. Of these sero-reactive patients, 13.4%(17/126) were positive for anti-HCV antibody, 0.79% (1/126)positive for HBsAg and none (0) for anti HIV antibody. Ofthe anti-HCV reactive cases, 70.5% (12 out of 17) were>12years of age, 58.8% (10 out of 17) had received morethan 250 transfusions, and 23.5% (4 out of 17) had receivedtransfusions between 100 to 250. Anti-HCV seroreactivitywas thus found to increase with the age and increase in thenumber of transfusions received.Conclusion: It is concluded that HCV is the most prevalentTTI in multi-transfused children with thalassemia major andstringent pre-transfusion screening of blood for anti-HCVmust be introduced in blood centers. HBV vaccination shouldalso be done before the start of transfusion regimen or as soonas possible after diagnosis of thalassemia.