• Karzan Mohammed Hasan Rauf Bag Hospital, DOH of Sulaimani, Kurdistan Region, Iraq.
  • Jamal Ahmad Rashid College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Ibrahim Khasraw Ghafoor Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.



Hepatitis C virus, Thalassemia major, Prevalence



Hepatitis C infection is a worldwide problem, especially in multi transfused patients including those with Thalassemia. Thalassemia is one of the inherited diseases, in which there is partial or complete failure of globin chain synthesis.


To evaluate the prevalence of hepatitis C virus infection in multiple blood transfused children with beta-thalassemia major and related risk factors.

Patients and Methods

A cross-sectional study was conducted on 459 patients (229 males and 230 females) with β-thalassemia major at Sulaimani thalassemia centre from January 2015 to June 2015. Data regarding age, sex, number of blood transfusions, chelating agents and history of splenectomy were obtained. Serum was used for detection of antibodies against hepatitis C virus, hepatitis B surface antibody, hepatitis B surface antigen and, human immunodeficiency virus, also in liver enzymes (Aspartate aminotransferase, Alanine aminotransferase) were checked. 


Sixty-four (13.9%) patients were found to be seropositive for anti-Hepatitis C virus antibodies; this was correlated with age, sex, history of splenectomy, number of blood transfusions and chelating agents. Liver enzymes were significantly higher in infected patients. The risk of exposure to hepatitis C virus was higher than the hepatitis B virus surface antigen and human immunodeficiency virus among the same patients.


Multi transfused thalassemic patients are at high risk for HCV infection, so more accurate techniques for screening of blood products is suggested.


- DeBaun MR, Frei-Jones MJ, Vichinsky EP. 'Hemoglobinopathies' in: Kliegman RM, Stanton BF, Schor NF, St Geme JW, Behrman RE. Nelson Textbook of Pediatrics, 20th Ed, 2016, Philadelphia, PA: Elsevier, pp. 2349-2352.

- Thein SL. Dominant beta thalassaemia: molecular basis and pathophysiology. Br J Haematol. 1992; 80(3):273-7.

- Nathan DG. Pioneers and modern ideas: prospective on thalassemia. Pediatrics.1998; 102:281-283.

- Dos Santos CO, Costa FF. alpha haemoglobin stabilizing protein (AHSP) and beta-thalassemia: a possible genetic modifier. Haematology. 2005; 10(2):57-61

- Weatherall, DJ. Thalassemia in the next millennium: Keynote address. Ann N Y Acad Sci 1998; 850:1.

- Rahav G, Volach V, Shapiro M, et al. Severe infections in thalassaemic patients: prevalence and predisposing factors. Br J Haematol 2006; 133:667.

- Jensen MK and Balistreri WF. 'Viral Hepatitis' in Kliegman RM, Stanton BF, Schor NF, St Geme JW, Behrman RE. Nelson Textbook of Pediatrics, 20th Ed, 2016, Philadelphia, PA: Elsevier, pp. 1949.

- Jean J., Sanio G., Francos L. Full or partial seroreversion in patients infected by HCV. The Journal of Infectious Dis.1997; 75: 316-322.

- Demontalembert M., Girof F., Mattlinger B. Transfusion dependent thalassemia: viral complication (epidemiology and follow up). Semin Hematology.1995; 32: 80-87.

- EL-Nanaway A., EL-Azzouni O.F., Solman A.T. Prevalence of hepatitis C-antibody seropositivity in healthy Egyptian children and four high-risk groups. Journal Trop. Pediatrics 1995; 41(6): 341-343.

- Al-Mahroos F. T., Ebrahim M. Prevalence of hepatitis B, hepatitis C and HIV among patients with hereditary H.A. Annal Trop. Pediatrics Journal 1995; 15 (2): l2l-128.

Al-Fawaz and Ramia S. Decline in hepatitis B infection in sickle cell anaemia and beta-thalassemia major. Archives of Disease in childhood 1993; 69: 594-596.

- Lau Y, Chaw CB, Lee AC. HCV antibodies in multi transfusion Chinese with thalassemia. Bone marrow Transplantation 1993; 12(1):26-28.

- Flynn P.M., Hepatitis C-infection. Pediatric annals 1996; 25(9):494-498.

- Muhammad Younus, Khalid Hassan, Nadeem Ikram. Hepatitis C Virus Seropositivity in Repeatedly Transfused Thalassemia Major Patients, International Journal of Pathology; 2004; 2(1):20- 23.

- El-Gohary A, Hassan A, Nooman Z. High prevalence of hepatitis C virus among urban and rural population groups in Egypt. Acta Trop 1995; 59 (2):155-61

- Jaiswal SP, Chitnis DS, Naik G. Prevalence of anti-HCV antibodies in central India. Indian J Med Res.1996; 104:177-81.

- Legler TJ, Riggert J, Simson G. Testing of individual blood donations for HCV RNA reduces the residual risk of transfusion-transmitted HCV infection. Transfusion.2000; 40: 1192-7.

- Donahue J G, Munoz A, Ness P M. The declining risk of post-transfusion hepatitis C virus infection; N. Engl. J. Med. 1992 ;327(6): 369–373.

- Mukhopadhya A Hepatitis C in India. J. Biosci. 2008; 33(4): 465–473.

- Thein SL. Dominant beta thalassaemia: molecular basis and pathophysiology. Br J Haematol. 1992; 80(3):273-7.)

- Al-Kubaisy WA, Al-Naib KT , Habib M .Seroprevalence of hepatitis C virus-specific antibodies among Iraqi children with thalassaemia. East Mediterr Health J. 2006; 12(1-2):204-10.

- Orhnan N. Mawlood, Ibrahim Kh. Ghafoor, Adnan M. Hasan. Prevalence of Hepatitis (C) Virus among Thalassemic Children in Sulaimani. Journal NI. 2014;1(2): 48-55.

- Tareef F. Raham, Salwa S. Abdul Wahed, Hadeer N. Alhaddad. prevalence of hepatitis c among patients with βthalasemia in Diyala- Iraq. AL-TAQANI Journal. 2011; 24(4):113-120.

- Abdul Karem J. Albahadle, Areege A, Ali H. Ali. Prevalence of hepatitis c infection among multi transfused thalassemia major patients in ibn-albalady center of thalassemia. QMJ.2013; 9(15): 73-84.

- A'alan H. AL-Zamili, Abass M. Al-shebani, Rahman K. Mohsin. Prevalence of hepatitis C viral infection among multi transfused thalassemic patients. QMJ. 2009; 5(7):89-99.

- Salem R, Jamal A. Rasheed, Ebrahem K. Prevalence of Hepatitis C among Multitransfused Thalassemic Children in Sulaimani. IPMJ.2005; 4(2):167-170.

- Chung JL, Kao JH, Kong MS. Hepatitis C and G virus infection in poly transfused children. Eur. Journal paediatrics 1997; 156(7): 546-549.

- Cacopardo B, Russ R, Fatuzz O. HCV infection among multi transfused thalassemic Patients. Transfusion med. 1992; 2(l): 69-70.

- Ghafourian Boroujerdnia M, Assareh Zadegan MA, Zandian KM, Haghirizadeh Rodan M. Prevalence of Hepatitis C virus (HCV) among Thalassemia Patients in Khuzestan Province Southwest Iran. Pak J Med Sci 2009; 25(1):113-117.

- Resti M, Azzari C, Rossi ME. Prevalence of anti-hepatitis C virus antibody in thalassemic poly transfused children in a long follow up Vox Sang.1991; 60:246-247.

- Frank C, Mohamed MK, Strickland GTl. The role of parenteral antischistosomal therapy in the spread of hepatitis C virus in Egypt. Lancet. 2000; 355(9207): 887-991.

- Saracco G, Sostegni R, Ghisetti V. Hepatitis C virus genotypes in a noncirrhotic Italian population with chronic hepatitis C: Correlation with clinical virological and histological parameters. Results of a prospective multicenter study. J Viral Hepat .2000; 7: 124-9

- Alter MJ, Kruszon-Moran D, Nainan OV. The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med .1999; 341(8): 556-62.

-. Borzini P, Cazzaniga G, Vecchi L. prevalence of anti-hepatitis C virus seroconversion in poly transfused thalassemic patients. Vox Sanguinis 1991; 60(3):188.



How to Cite