Hidden burden: Hepatitis C virus infection among multi-transfused thalassemic children in Gujarat

• Author Details:   
• Saurabh Chhotalal Norris
• Pankti C Pargi ^*
• Binda Prakashbhai Pipaliya
• Rachana Dhirubhai Patel
• Tanuja Bakul Javadekar

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Background: Thalassemia is a genetic hemoglobinopathy leading to chronic anemia, frequently requiring regular blood transfusions. Recurrent transfusions elevate the risk of transfusion-transmitted infections (TTIs), including hepatitis B virus (HBV), hepatitis C virus (HCV), HIV, and syphilis. Iron overload also remains a serious complication. This study aimed to assess the prevalence of HCV infection in β-thalassemia major children receiving multiple transfusions.

Materials and Methods: A cross-sectional study was conducted at the Department of Microbiology, tertiary care centre, Vadodara, from February to July 2024. A total of 119 thalassemic children with regular transfusion history were included. Serum samples were first screened using the Qualisa third-generation ELISA for anti-HCV antibodies. All ELISA-reactive samples were further confirmed using qualitative real-time PCR to detect HCV RNA, ensuring diagnostic precision. Demographic and transfusion data were collected through caregiver interviews.

Results: Out of 119 participants, 16 (13.45%) were confirmed HCV RNA-positive using qualitative PCR. The highest prevalence was noted in the 9–12 years age group. A strong correlation was observed between the number of transfusions and HCV positivity, with a 60% positivity rate in those who received more than 100 transfusions. Additional factors such as rural residence, splenectomy, and lack of chelation therapy were associated with higher HCV rates.

Conclusion: This study emphasizes the high burden of HCV among multi-transfused thalassemic children and advocates for routine NAT/PCR screening and continuous HCV surveillance in high-risk pediatric groups.