Abstract
Objectives: To report the clinical and virologic epidemiology of a recent epidemic of hepatitis C in thalassaemia patients in Sri Lanka. Background: Transfusion-dependent thalassaemia patients remain at risk for hepatitis C virus (HCV). Here, we report a cluster of recent HCV infections in Sri Lankan thalassaemia patients and examine the phylogenetic relationship of viral sequences. Methods: We conducted two prospective cross-sectional surveys of 513 patients in four Sri Lankan thalassaemia centres in 2014/2015 and re-surveyed one centre in 2016. We screened for anti-HCV antibodies using the CTK Biotech enzyme-linked immunosorbent assay (ELISA) kits and confirmed active infection by reverse transcription-polymerase chain reaction (RT-PCR) for HCV-RNA. HCV genomes were sequenced by unbiased target enrichment. Results: Anti-HCV antibodies were found in 116/513 (22.6%) of patients initially tested. Active hepatitis C infection was found in 26 patients with no cases of active hepatitis B infection. Of 26 patients with HCV, two were infected with genotype 1(a), and the rest had 3(a). In a single centre (Ragama), 122 patients (120 new cases and two previously tested, but negative) were retested for anti-HCV antibodies. 32/122 (26.2%) patients were seropositive. Twenty-three (23/122; 18.8%) of these new cases were confirmed by HCV PCR (all genotype 3[a]). Conclusion: There is a significant cluster of recent HCV cases in multiply transfused thalassaemia patients in several centres in Sri Lanka. Most of the viruses shared a close phylogenetic relationship. The results are consistent with recent continuing transfusion-transmitted HCV infection. Routine surveillance for HCV of chronically transfused patients is required irrespective of screening of blood products.
| Original language | English |
|---|---|
| Pages (from-to) | 377-383 |
| Number of pages | 7 |
| Journal | Transfusion Medicine |
| Volume | 30 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 1 Oct 2020 |
| Externally published | Yes |
Bibliographical note
Funding Information:The Authors wish to acknowledge the contribution of Dr. Sanjaya Weerasinghe, Dr. Taraka Pilapitya, and Mr Rexan Rodrigo who helped in the collection of samples. We would also like to thank Rory Bowden, Eleanor Barnes, and the Oxford Viromics initiative for providing lab support for the sequencing. The study received some funding from Anthony Cerami and Ann Dunn Foundation. We are also grateful to Prof Sir Nicholas J. White for support for laboratory analyses. AP., S.P., and M.N, devised the study, S.P., P.C.A., U.B.N., D.R., and I.D.S. collected samples and provided clinical data, S.P., D.B., and M.D.C. analysed clinical samples A.P., D.B., S.P., M.N., and A.A. analysed data, A.P., M.N., and D.J.R. wrote the drafts, all authors reviewed the final manuscript. GenBank accession numbers BankIt2277285 SL11 MN628574 BankIt2277285 SL12 MN628575 BankIt2277285 SL16 MN628576 BankIt2277285 SL17 MN628577 BankIt2277285 SL18 MN628578 BankIt2277285 SL1 MN628579 BankIt2277285 SL20 MN628580 BankIt2277285 SL21 MN628581 BankIt2277285 SL22 MN628582 BankIt2277285 SL23 MN628583 BankIt2277285 SL24 MN628584 BankIt2277285 SL27 MN628585 BankIt2277285 SL29 MN628586 BankIt2277285 SL31 MN628587 BankIt2277285 SL32 MN628588 BankIt2277285 SL33 MN628589 BankIt2277285 SL34 MN628590 BankIt2277285 SL35 MN628591 BankIt2277285 SL36 MN628592 BankIt2277285 SL37 MN628593 BankIt2277285 SL3 MN628594 BankIt2277285 SL4 MN628595 BankIt2277285 SL7 MN628596 BankIt2277285 SL8 MN628597.
Funding Information:
The Authors wish to acknowledge the contribution of Dr. Sanjaya Weerasinghe, Dr. Taraka Pilapitya, and Mr Rexan Rodrigo who helped in the collection of samples. We would also like to thank Rory Bowden, Eleanor Barnes, and the Oxford Viromics initiative for providing lab support for the sequencing. The study received some funding from Anthony Cerami and Ann Dunn Foundation. We are also grateful to Prof Sir Nicholas J. White for support for laboratory analyses. AP., S.P., and M.N, devised the study, S.P., P.C.A., U.B.N., D.R., and I.D.S. collected samples and provided clinical data, S.P., D.B., and M.D.C. analysed clinical samples A.P., D.B., S.P., M.N., and A.A. analysed data, A.P., M.N., and D.J.R. wrote the drafts, all authors reviewed the final manuscript. GenBank accession numbers BankIt2277285 SL11 MN628574 BankIt2277285 SL12 MN628575 BankIt2277285 SL16 MN628576 BankIt2277285 SL17 MN628577 BankIt2277285 SL18 MN628578 BankIt2277285 SL1 MN628579 BankIt2277285 SL20 MN628580 BankIt2277285 SL21 MN628581 BankIt2277285 SL22 MN628582 BankIt2277285 SL23 MN628583 BankIt2277285 SL24 MN628584 BankIt2277285 SL27 MN628585 BankIt2277285 SL29 MN628586 BankIt2277285 SL31 MN628587 BankIt2277285 SL32 MN628588 BankIt2277285 SL33 MN628589 BankIt2277285 SL34 MN628590 BankIt2277285 SL35 MN628591 BankIt2277285 SL36 MN628592 BankIt2277285 SL37 MN628593 BankIt2277285 SL3 MN628594 BankIt2277285 SL4 MN628595 BankIt2277285 SL7 MN628596 BankIt2277285 SL8 MN628597.
Publisher Copyright:
© 2020 British Blood Transfusion Society
