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دراسة خمج فيروس الكبد نمط جي HGV في مرضى الثلاسيميا المصابين وغير المصابين بفيروس الكبد سي (HCV) واهميته السريرية
Author name:
مريم صبري ابراهيم
Supervisor name:
اروى هادي الحمداني | اشنا جمال فائق
General topic:
Medicine
Specific topic:
Microbiology - Viruses
Degree:
Master
University:
Mustansiriyah University
Language:
English
University location:
Baghdad
First pages:
19T1147 - p.pdf
Abstract:
المرضى المصابين بفقر دم البحر الابيض المتوسط هم اكثر عرضة للاصابة بالالتهابات الفيروسية المنقولة دمويا. التهاب الكبد الفيروسي نمط جي (HGV)هو فيروس رنوي(RNA) مرتبط بالتهاب الكبد الفيروسي الحاد والمزمن. التهاب الكبد الفيروسي نمط سيHCV) ) والتهاب الكبد الفير | Thalassemia patients are at increased risk of infection with parentally transmitted viral agents. The hepatitis G virus (HGV) is an RNA virus, which is associated with acute or chronic hepatitis. Hepatitis G virus (HGV) and hepatitis C virus (HCV) infections may have a role in complicating the clinical outcome in patients with thalassemia. This study was designed to investigate the prevalence and clinical importance of HGV infection in thalassemia patients with or without hepatitis C virus (HCV) co - infection, furthermore to sequence and analyze phylogentic of HGV clones. One hundred fifty four thalassemia patients (56.5% male, 43.5% female) with a mean age of 22.84±6.06 years were involved in this study that was conducted in the period between Feb. to May, 2014. Anti - HCV antibody was determined by Enzyme Linked Immunosorbent Assay (ELISA) and confirmed by western blot. Then, HCV - RNA was detected in 53.2% of anti - HCV positive thalassemia patients. HGV antibodies were evaluated by ELISA. Also, the HGV viremia was analyzed in patients with thalassemia by reverse transcription polymerase chain reaction (RT - PCR) protocol. Results obtained showed that the anti - E2 - HGV were found in 16 out of 154 (10.4%) thalassemia patients with significant decrease in its prevalence with increasing age, while HGV viremia was diagnosed in 28 out of 154 (18.2%) patients with thalassemia. No association of HGV infection was found with gender, age and frequency of blood transfusion.According to HCV and HGV infection status, thalassemia patients were categorized into four subgroups : subgroup I (HGV infection), subgroup II (HCV infection), subgroup III (co - infection of HCV and HGV), and subgroup IV (thalassemia patients with neither HCV nor HGV infection). Seven point one percent (7.1%) of thalassemia patients were found to be co - infected with HCV and HGV.In all thalassemia subgroups, liver transaminases; alanine transaminase (ALT) and aspartate transaminase (AST), alkaline phosphatase (ALP), and total serum bilirubin (TSB) were determined, in addition to measure serum ferritin levels by VIDAS. HCV infection shows significant increase in ALT level while in HGV is not. Co - infection with HCV and HGV decrease ALT levels when compared with infection with HCV alone, so HGV infection is suggested to have no role in increasing the severity of liver diseases in the thalassemia patients. In HGV infection, there were significant increase in ALP levels and significant decrease in ferritin levels than other subgroups in the study. However, HGV infection shows no significant differences in AST and TSB than other subgroups. The results of genotyping in 12 randomly selected patients showed presence of genotype 2 and genotype 5 with percentage of 91.7% and 8.3% respectively. The diagnosis of prevalence of HGV and HCV in patients with thalassemia in Iraq emphasized the importance of these lymphotropic viral hepatitis infections in pathogenesis and outcome of thalassemia patients.
