Transfusional transmitted viruses in pregnancy

Blood has long been recognized as a vehicle for transmission of infectious organisms and as molecular laboratory technology has advanced, a seemingly endless array of infectious agents has occasionally been documented to be b lood transmitted, Transfusion associated hepatitis (TAH) has been the most common serious consequence of blood transfusion although in recent years th is has been significantly reduced (blood donor screening, blood processing, etc.). Thalassaemia major is classically associated with increased suscept ibility to infections caused by those agents that are blood transmitted suc h as HBV, HCV, HIV, CMV, HPV B-19 (frequency rates vary from country to cou ntry). Monitoring the prevalence of transfusion transmitted infections in t halassaemics has been in recent years an indispensable part of their clinic al management protocol, As a number of these viruses have been documented t o be efficiently transmitted through the vertical route, the issue of blood transmitted viral infection monitoring becomes particularly important in o rder to provide protection or treatment both to the pregnant thalassaemic p atient herself and to her foetus/newborn, Hepatitis (mainly B and C) and HI V in the obstetric thalassaemic is what the clinician is faced with most fr equently. Although preventative measures have been very successful in the c ase of HBV infection and recently to an encouraging extent in the case of H IV (recommendations have been constructed), the mechanisms and frequency of HCV vertical transmission as well as the clinical outcome of children born to HCV carriers are not yet completely clarified. No vaccines are availabl e and HIGH or antivirals do not appear to offer protection to the foetus ag ainst infection with HCV, Thalassaemics are frequently seropositive to mark ers of other transfusion transmitted viruses, such as CMV and HPV B-19, par ticularly by the age of pregnancy. Infection with a second or multiple stra ins as well as reactivation of existing CMV strain(s) are possible events i n thalassaemics, However, the frequency of "recurrency" episodes, their imp lication in vertical transmission and clinical outcome for the foetus/newbo rn are issues requiring further investigation.