Abstract
ObjectivesTo determine the prevalence of hepatitis B, hepatitis C, and human immunodeficiency virus (HIV) in chronically transfused β-thalassemia major (TM) patients, and to assess their quality of life (QoL).MethodsThis cross-sectional study was conducted in three different thalassemia centers located in Peshawar, Khyber Pakhtunkhwa from January to July 2019. These centers provide screened blood and essential medical care for thalassemia patients. These centers include the Fatimid Foundation, Hamza Foundation, and Rehman Medical Institute, Peshawar, Khyber Pakhtunkhwa. A total of 431 blood transfusion-dependent β-thalassemia patients registered at these centers were selected. QoL in β-TM patients was assessed by a newly developed instrument, the TranQoL questionnaire. For the data analysis procedure, Microsoft Excel and Statistical Package for the Social Sciences; version 22 (SPSS Inc., Chicago, IL) was used.ResultsA total of 431 patients were included in our study. The ages ranged from five years to 23 years with a mean age of 11.54 ± 3.6 years; 58.93% were male and the rest were female with a male to female ratio of 1.43:1. A total of 129 (29.93%) patients were infected by transfusion-transmitted infections (TTIs). Hepatitis C virus (HCV) was found prevalent in 23.66%, hepatitis B virus (HBV) was found in 4.87%, and HIV was found prevalent in 1.39% cases. The results showed a high proportion of HCV in males 27.95% as compared to females 17.51% (p value = 0.31). Patients were divided into high (good) QoL score of >50 and low (poor) score of <50. In patients with hepatitis C, the QoL was poor in 90 (88.23%) patients and was good in only 12 (11.76%) patients (p value=0.01); in the hepatitis B group, it was good in only eight (38.09%) and poor in 13 (61.90%) patients (p-value 0.04), and for patients with HIV, it was poor in all six patients (p=0.001).ConclusionOur study concludes that transfusion-transmitted disease is very high and that HCV is the leading TTI followed by HBV and HIV. QoL in patients with TTIs was poor. The use of advanced technology in blood screening, voluntary donations, donor selection, and asepsis during blood transfusion is imperative to curtail the transmission.
Highlights
Thalassemia is a group of hereditary hemolytic disease caused by decreased or absent production of the alpha or beta-globin chain
A total of 129 (29.93%) patients were infected by transfusion-transmitted infections (TTIs)
Hepatitis C virus (HCV) was found prevalent in 23.66%, hepatitis B virus (HBV) was found in 4.87%, and human immunodeficiency virus (HIV) was found prevalent in 1.39% cases
Summary
Thalassemia is a group of hereditary hemolytic disease caused by decreased or absent production of the alpha or beta-globin chain. Thalassemia is the most common form of single gene disarray. In Pakistan, the carrier frequency of β-thalassemia is nearly 5%-7% and in general 4,000 to 9,000 cases are added yearly [2]. Routine blood transfusions and iron chelation are a standard of care in thalassemia, and the life expectancy of patients have elevated incredibly [3,4]. During the main treatment in β-thalassemia, major blood transfusion therapy at routine intervals depends upon the nature of the mutation. Blood transfusion at regular intervals leads to certain complexities like iron overload and transfusion mediated infection in thalassemia patients [5]. In developing countries like Pakistan, the most common blood transmitted infection are hepatitis B, hepatitis C, human immunodeficiency virus (HIV), syphilis, and malaria [6]
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