The Seroprevalence of Entrically Transmitted Viral Hepatitis in HCV Infected Thalassemia and Hemophilia Patients in Iran

Abstract

Background: Hepatitis A and E virus (HAV and HEV) infections are acute and self-limited diseases that usually spread through oral-fecal route. Also, blood transfusion as a possible route of entrically transmitted hepatitis has been suggested. Hemophilia and thalassemia patients are highly at risk of transfusion-transmissible viruses (HBV, HCV, and HIV). Any superimposed infection with other viral hepatitis (in particular hepatitis A) cause active liver failure in hemophilia and thalassemia patients. Objectives: The aim of this study is to consider seroprevalence of anti HAV and HEV antibodies (Ab) in thalassemia and hemophilia patients with chronic hepatitis C in Iran. Patients and Methods: In a cross-sectional study and under general census sampling, sera of 219 thalassemia and hemophilia patients infected with HCV were examined in Tehran Hepatitis Center (THC) between 2009 and 2010. Enzyme-linked immunisorbentassey (ELISA) was done to observe anti HAV and HEV IgG Ab. Patients were chosen from all provinces of Iran. Results: Anti-HAV IgG antibodies were observed more frequently in thalassemia patients (60/64; 93.8%) than in hemophilia patients (104/155; 67.1%, P < 0.001). The seroprevalence of both antibodies increased with age. Among thalassemia patients, there was no significant association between HAV seropositivity and other variables, but in hemophilia group, seropositive patients were significantly older than seronegative group (P < 0.05). Totally, anti HEV Ab (1/64; 1.6% thalassemia and 5/155; 3.2% hemophilia) was seropositive in six patients. There was no significant association between HEV infection and other variables in thalassemia patients, however, in hemophilia patients, HEV positive ones were significantly older than HEV negative group (P=0.01). Conclusions: Vaccination of non-immune individuals against HAV infection in high risk groups especially hemophilia and thalassemia patients is recommended. Results did not show any differences about seroprevalence of HEV among Iranian general population.