A comprehensive five-year study of Hepatitis C Virus infection and its transmission dynamics in multi-transfused β-globin defective patients in the state of West Bengal, India

BackgroundPost transfusion acquired HCV infection is common in high-risk group individuals such as multi-transfused {beta}-thalassemia patients who depend on regular blood transfusions. This study was conducted to determine epidemiology and distribution of HCV in multi-transfused {beta}-thalassemia patients, in West Bengal, India. MethodsOver a span of six years blood samples were collected from HCV sero-reactive {beta}-thalassemic patients and processed for viral RNA isolation followed by nested RT-PCR for qualitative viremia detection. HCV genotype was determined by amplifying partial HCV core gene by nested RT-PCR, DNA sequencing and using NCBI genotyping tools. Phylogenetic and phylogeographic studies were performed with online MEGA-X and BEAST 1.10.0 software respectively. ResultsOut of 917 multi-transfused HCV sero-reactive {beta}-thalassemic patients, 598 (65.21%) were positive for HCV RNA while 250 (41.80%) had spontaneously cleared the virus. Female thalassemic patients and individuals belonging to ages 10-14 years had higher chances of spontaneous clearance. The most prevalent circulatory HCV genotype was 3a (78.11%) followed by 1b (12.20%). Phylogeographic analyses revealed that the 3a strains share similarity with Pakistan, Sri Lanka and Thailand whereas the 1b strains share similarity with Thailand, Vietnam, Russia and China. ConclusionThe prevalence of HCV infection is very high among Indian {beta}-thalassemic patients, necessitates a critical look into the prevailing transfusion practices and requires implementation of more rigid donor screening criteria to decrease the rate of transfusion transmitted HCV infection, especially in multi-transfused thalassemic patients. The use of more sensitive NAT based assays for HCV detection in donor blood is a compressing need of the hour.