Hepatitis C Virus (HCV) Transmitted Transfusion Risk Among β-Thalassemia Patients in Egypt

Abstract

Abstract Introduction: β-Thalassemia is an inherited abnormal condition that results in hemolytic anemia. It is the most common monogenic disorder in the world. The Mediterranean countries have the highest prevalence of β-thalassemia (2%-18%), and in Egypt, it is 9% to 10%. Regular multiblood transfusion and iron chelation are the major line of therapy for thalassemic patients. There are relatively low blood transfusion safety standards in the Third World countries. Hepatitis C virus (HCV) has the highest risk of transfusion transmitted diseases and Egypt has the highest HCV prevalence worldwide. Method: Our study is aimed to assess the risk of HCV transmitted to thalassemic patients that receive regular blood transfusions by focusing on the statistics of this population. The study covered most Egyptian governorates from Nile Delta and Upper Egypt by collecting patients’ data between 2015 and 2018. Results: Consecutive studies were done on 946 β-thalassemic patients as demonstrated from the following: Cairo (205), Mansoura (36), Tanta (120), Damanhur (125), Alexandria (119), Zagazig (73), AlFayoum (121), and Sohag and Minia (147). Studies showed that the HCV-transmitted infection in thalassemia patients in Upper Egypt were detected at 37%, while some Nile Delta studies illustrated that 20% were infected with HCV from transfused thalassemia patients due to multiple blood transfusions. Conclusion: Blood transfusion–transmitted hepatitis C virus has a very high rate among Egyptian thalassemic patients compared to the worldwide rate. Common anti-HCV antibody screening assay has a low sensitivity and specificity compared to nucleic acid amplification testing (NAT). Therefore, our study recommends following the American Association of Blood Bank (AABB) guidelines for blood donation screenings and implementation of viral NAT testing to reduce the risk of viral transmission during the “window period.” This will reduce the time for effective detection from 70 to 10 days for HCV.