Prevalence of occult hepatitis C virus infection in beta-thalassemia major patients in Ahvaz, Iran.

Sepideh Nasimzadeh,Seyed Saeid Seyedian,Shahram Jalilian,Bijan Keikhaei,Fateme Jahangiri Mehr,Manoochehr Makvandi,Azarakhsh Azaran

doi:10.1007/s00705-021-05126-7

Sepideh Nasimzadeh, Seyed Saeid Seyedian + Show 5 more

Open Access

https://doi.org/10.1007/s00705-021-05126-7

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Abstract

Occult hepatitis C virus infection (OCI) is defined by the presence of HCV RNA in peripheral blood mononuclear cells (PBMCs) and liver tissue cells despite the absence of HCV RNA in plasma. Currently, OCI is classified into two types: seropositive OCI (anti-HCV positive and serum HCV RNA negative) and seronegative OCI (anti-HCV and serum HCV RNA negative). Beta-thalassemia is described as a blood disorder that decreases the synthesis of hemoglobin. Repeated blood transfusion is the standard treatment for patients with beta-thalassemia major (BTM), and this increases the risk of exposure to infectious agents. The aim of this study was to investigate the prevalence of OCI among BTM patients. Plasma and PBMCs were collected from 90 BTM patients who were referred to Shafa Hospital in the city of Ahvaz and were screened for HCV antibody using a commercial ELISA kit as the first step. Next, nested RT-PCR was performed on extracts of plasma and PBMCs. HCV RNA from positive PBMCs was sequenced, the sequences were aligned, and a phylogenetic tree was constructed to determine their relationship to reference sequences retrieved from the GenBank database. Seventy-nine out of 90 patients (87.8%) were negative for HCV Ab (seronegative), while 11 patients (12.2%) were seropositive. HCV RNA was found in PBMCs of four patients (66.7%) who were negative for HCV Ab (seronegative) and two patients (33.3%) who were positive for HCV Ab (seropositive). HCV RNA was not detected in plasma samples from these six patients. Six out of 90 BTM patients (6.7%) had OCI. HCV genotyping revealed that all six patients were infected with HCV subtype 3a. We found a high frequency of OCI in BTM patients, which warrants more attention, considering the importance of this infection. Further studies are needed to determine the actual prevalence of OCI in BTM patients in Iran.

Highlights

Hepatitis C Virus (HCV) is an enveloped positive single-stranded RNA virus belonged to the Flaviviridae family and Hepacivirus genus [1]
The RT-Nested PCR results for the HCV 5'-UTR revealed that 24 cases (26.7%) in their plasma were positive for HCV-RNA, and excluded from the study owing to overt HCV infection
The findings revealed that six out of 66 remaining patients (9.1%) were positive for HCV-RNA in their peripheral blood mononuclear cells (PBMCs), demonstrating Occult hepatitis C virus infection (OCI) in these patients

Summary

Introduction

Hepatitis C Virus (HCV) is an enveloped positive single-stranded RNA virus belonged to the Flaviviridae family and Hepacivirus genus [1]. Studies conducted on the general Iranian population found the estimated HCV infection prevalence to be 0.5% [8]. Occult hepatitis C virus infection (OCI) is defined by the presence of HCV RNA in peripheral blood mononuclear cells (PBMCs) and liver tissue cells despite the absence of HCV RNA in plasma. Materials and Methods: plasma and PBMCs were collected from 90 BTM patients and screened for HCV antibody using the ELISA kit commercially as the first step. HCV RNA was found in PBMCs samples of four patients (66.66%) with negative HCV Ab (seronegative) and two patients (33.3%) with positive HCV Ab (seropositive). HCV RNA was not detected in plasma samples of these six patients. HCV genotyping revealed that all six patients infected with HCV subtype 3a

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