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دراسة التنميط الجيني لفيروس تي تي في مرضى الثلاسيميا المصابين وغير المصابين بفيروس التهاب الكبد نمط ج
Author name:
ابتسام نايف عودة الجبالي
Supervisor name:
اروى هادي الحمداني
General topic:
Medicine
Specific topic:
Microbiology - Viruses
Degree:
Master
University:
Mustansiriyah University
Language:
English
University location:
Baghdad
First pages:
19T1131 - p.pdf
Abstract:
ما زال الكثيرون لا يعرفون الاهمية السريرية لفيروس تي تي الذى رشح كاحد فايروسات التهاب الكبد انماط A - G)).ان فيروس تي تي يصيب المرضى المعرضين لخطر الحقن ونقل الدم المتكرر، كما في المرضى المصابين بفقر دم البحر الابيض المتوسط(? - Thalassemia major). تمت هذة | Much is still unknown about the clinical significance of TT virus (TTV) that has been reported as a candidate for non A - G hepatitis virus. TTV infects patients at risk for parenteral exposure and chronic blood transfusion, such as those with ? - thalassemia major. This study was designed to investigate the prevalence and clinical importance of TTV infection in thalassemia patients with or without hepatitis C virus (HCV) co - infection, furthermore to sequence and analyse phylogentic of TTV clones.One hundred fifty four thalassemia patients (64.3% male, 35.7% female) with a mean age of 23.8±6.8 years were involved in this study that was conducted in the period between Feb. to Dec. 2013. TTV DNA was detected using Real time PCR. Furthermore, conventional PCR was done for sequencing and phylogenetic analysis using N22 region from open reading frame 1 (ORF1). Anti - HCV antibody was determined by Enzyme Linked Immunosorbent Assay (ELISA) and confirmed by western blot. Then, HCV core antigen was detected in those anti - HCV Abs seropositive samples. Liver transaminases (ALT, AST) were determined, in addition to measure serum ferritin levels by VIDAS ferritin. TTV was detected in 45 of 154 (29.2%) of thalassemia patients with predominance of males than females (64.4% vs. 35.6%). The prevalence rate of anti - HCV Abs were 54.5% with significant increase in females than males (p<0.05).Out of these 84 samples, 59 (70.2%) were positive by HCV core Ag assay and related significantly to frequency of blood transfusion. According to HCV and TTV infection status, patients were categorized into six groups : Anti - HCVAb+ HCV core Ag + TTV+, Anti - HCVAb+ HCV core Ag + TTV - , Anti - HCVAb+ HCV core Ag - TTV+, Anti - HCVAb+ HCV core - TTV - , Anti - HCVAb - TTV+, Anti - HCVAb - TTV - . The increased levels of ALT, AST and ferritin in the HCV and TTV infected group were not significantly different from those in the TTV and HCV negative groups. Co - infection of TTV and HCV were significantly increase ALT levels compared to infection with HCV alone. No association of TTV infection was found with gender, age and frequency of blood transfusion.The results of genotyping in 12 randomly selected patients showed the presence of equal percentage of genotype 1 (G1) and genotype 2 (G2) 50% for each one, with homology between them 79.0%. Other TTV genotypes were not identified in the present study suggesting that G1and G2 are predominant in this area. Mixed infection of the same patient with multiple TTV genotypes was observed. The results concluded that TTV is moderately present in Iraqi thalassemia patients, with G1 and G2 were predominant. Patients co - infected with HCV and TTV had a significantly higher serum ALT level than those without TTV infection, so TTV infection is suggested to have a role in increasing the severity of liver diseases in the thalassemia patients when co - infected with HCV.
