SEROLOGICAL MONITORING OF THALASSEMIA MAJOR PATIENTS FOR TRANSFUSION-ASSOCIATED VIRAL-INFECTIONS

A total of 39 patients with thalassaemia major who received multiple b lood transfusions were followed up clinically and seroiogically for 3 successive years (1993, 1994, 1995). They were screened for hepatitis B surface antigen (HBsAg), and antibodies to hepatitis B core (HBc-tot al), hepatitis C virus (HCV), human immunodeficiency virus I and II (H IV-I/II) and cytomegalovirus (CMV-total). In spite of transfusing HBsA g screened (by third generation ELISA) blood from voluntary non-remune rated donors, there was a significant increase of HBsAg positivity (P< 0.001) from 17.9 per cent (1993) to 35.9 per cent (1994) to 69.2 per c ent (1995). This was probably due to the prevalence of undetectable RE V infection in the population. Anti HBc was present in 17 (43.6%), 14 (35.9%) and 16 (41%) patients in consecutive years. An increase in the units of blood transfused was observed every year. Blood units were n ot screened for anti HCV antibodies but a gradual increase in positivi ty [9 (23%), 12 (30.7%) and 14 (35.9%) patients] was seen in consecuti ve years. Anti-HIV antibodies were found in a 16 yr old male who was i ncluded in the study without any clinical evidence of AIDS. Anti CMV a ntibody was found in 30 (76.9%), 32 (82%) and 29 (74.3%) patients with out any apparent clinical infection. Some patients showed change of an tibody pattern (from negative to positive or vice versa) and a few pat ients showed inconsistent results probably due to immune modulation. R ecruitment of 'repeat' non-remunerated voluntary blood donors may redu ce the risk of high HBV transmission.