نوع مقاله : مقاله پژوهشی

نویسندگان

1 دکترای حرفه‌ای پزشکی، دانشکده پزشکی، واحد پردیس، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران

2 دکترای تخصصی ویروس‌شناسی، گروه ویروس‌شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران

3 استاد ویروس‌شناسی پزشکی، گروه ویروس‌شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران

4 دانشیار ویروس‌شناسی پزشکی، گروه ویروس‌شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران

چکیده

 
زمینه و هدف: آگاهی از شیوع هپاتیت E می‌تواند شاخصی برای سلامت و بهداشت عمومی باشد. ﻭﻳﺮﻭﺱ هپاتیت E از عوامل شایع هپاتیت حاد در افراد بالغ است. اگرچه راه اصلی انتقال هپاتیت E، از طریق مدفوعی-دهانی است؛ گزارش­هایی مبنی بر انتقال از راه خون منتشر شده است. مطالعه حاضر با هدف بررسی سرواپیدمیولوژی ﻭﻳﺮﻭﺱ هپاتیت E (HEV) در بیماران تالاسمی ماژور در شهر اهواز انجام شده است.
مواد و روش­ها: این مطالعه مقطعی، بر روی 88 بیمار مبتلا به تالاسمی ماژور که برای دریافت خون ماهانه در بازه زمانی 6 ماه در سال 1398 به درمانگاه شفا در شهر اهواز مراجعه کرده بودند، انجام شد. برای تشخیص آنتی‌بادی های IgM وIgG بر علیه HEV از آزمون الیزا استفاده شد. سپس تمام نمونه ها جهت تشخیص RNA ویروس، تحت  RT-PCR قرار گرفت. داده های حاصل با آزمون‌های آماری تجزیه‌وتحلیل شد.
یافته­ها: از 88 بیمار مورد بررسی، Anti-HEV IgG در 10 نفر (36/11%) و Anti-HEV IgM در 6 نفر (81/6%) گزارش شد. HEV RNA با روش RT-PCR در هیچ­کدام از نمونه­ها یافت نشد. ارتباط آماری معناداری بین آنتی­بادی علیه HEV با سن و جنس وجود نداشت؛ در حالی­که بین عفونت HEV و تعداد انتقال خون ارتباط معنی­داری مشاهده شد (02/0=P).
نتیجه‌گیری: این مطالعه نشان داد که باتوجه‌به وجود Anti-HEV IgG - علیرغم عدم وجود ویروس در خون- بیماران در گذشته به HEV مبتلا شده و میزان شیوع در جمعیت مورد مطالعه، بالا بوده که نشان­دهنده اندمیک‌بودن این عفونت در جامعه است.

تازه های تحقیق

https://scholar.google.com/citations?hl=en&user=gBhpNzIAAAAJ

https://pubmed.ncbi.nlm.nih.gov/?term=Kimia+Makvandi

https://scholar.google.com/citations?hl=en&user=rVfEUbgAAAAJ

https://pubmed.ncbi.nlm.nih.gov/?term=Roya+Pirmoradi

https://scholar.google.com/citations?user=P5ZAOoMAAAAJ&hl=en

https://pubmed.ncbi.nlm.nih.gov/?term=manoochehr+makvandi

https://scholar.google.com/citations?hl=en&user=YVxpLgQAAAAJ

https://pubmed.ncbi.nlm.nih.gov/?term=Azarakhsh+Azaran

 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Seroepidemiology and Molecular Investigation of Hepatitis E Virus in Patients with Major Thalassemia in Ahvaz City

نویسندگان [English]

  • Kimia Makvandi 1
  • Roya Pirmoradi 2
  • Manoochehr Makvandi 3
  • Azarakhsh Azaran 4

1 GP. School of Medicine, Pardis branch, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 PhD in Medical Virology. Department of Medical Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

3 Professor in Medical Virology. Department of Medical Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

4 Associate Professor in Medical Virology. Department of Medical Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

چکیده [English]

Background: Knowledge regarding prevalence of Hepatitis E Virus (HEV) can be an indicator of the public health and hygiene. HEV is the main cause of acute hepatitis in adult patients. Although the main route of its transmission is through the fecal-oral route, reports have been published about the transmission of this virus through blood transfusion. This study aimed to determine seroepidemiology of hepatitis E virus among thalassemia major patients in Ahvaz, Iran.
Materials and Methods: In this descriptive cross-sectional study, 88 patients with beta-thalassemia major admitted to Shafa Clinic in Ahvaz, Iran, to receive blood monthly in a period of 6 months in 2018, were included in the study. An ELISA kit was used to detect anti HEV IgM and IgG Ab. RT-PCR was used for RNA detection from all samples. The obtained data were statistically analyzed.
Results: Out of 88 patients, 10 (11.36%) were positive for HEV IgG; and the prevalence of HEV IgM was determined in 6 patients (6.81%) with the ELISA method. RT-PCR showed that none of the samples contained the virus. There were no significant relation between anti HEV Ab and variables such as age and gender. There was a significant association between HEV infection and frequency of blood transfusion (P = 0.02).
Conclusion: In this research, despite the absence of the virus in the blood, patients had hepatitis and were likely to transmit the virus through infected blood. The prevalence of the HEV in the study population is high, showing that the infection is endemic in the community.
 

کلیدواژه‌ها [English]

  • Hepatitis E virus
  • Immunoglobulin M
  • Immunoglobulin G
  • Prevalence
  • Enzyme-Linked Immunosorbent Assay
  • Beta-Thalassemia
  1. Norasteh H, Mohammadi Sh, Nikravesh M, Taraz Jamshidi Sh. Protective Effect of Bene (Pistacia Atlantica) on Busulfan-Induced Renal-Liver Injury in Laboratory Mice. J Babol Univ Med Sci. 2020; 22: 17-23. dorl.net/dor/20.1001.1.15614107.1399.22.1.3.5.
  2. Wang H, He Y, Shen Q, Wang X, Yang S, Cui L, Ren L, Sun G, Hua X, Shao S, Zhang W. Complete genome sequence of the genotype 4 hepatitis E virus strain prevalent in swine in Jiangsu Province, China, reveals a close relationship with that from the human population in this area. J Virol .2012; 86(15):8334-5. doi:1128/jvi.01060-12.
  3. Nazer MR, Rafii Alavi E, Hashemi SJ. Investigation of the serological prevalence of hepatitis E in Khorramabad city in 2018. Journal of Shahid Sadoughi University of Medical Sciences and Health Services, Yazd. 1389;18(5):451-60. (Persian)
  4. Aslan AT, Balaban HY. Hepatitis E virus: Epidemiology, diagnosis, clinical manifestations, and treatment. World journal of gastroenterology. 2020 7;26(37):5543. doi: 10.3748/wjg.v26.i37.5543.
  5. Lhomme S, Marion O, Abravanel F, Izopet J, Kamar N. Clinical manifestations, pathogenesis and treatment of hepatitis E virus infections. Journal of clinical medicine. 2020 Jan 24;9(2):331. doi: 3390/jcm9020331.
  6. Kamar N, Dalton HR, Abravanel F, Izopet J. Hepatitis E virus infection. Clinical microbiology reviews. 2014 Jan;27(1):116-38. doi.org/10.1128/cmr.00057-13.
  7. World Health Organization. Hepatitis E. https://www.who.int/news-room/fact-sheets/detail/hepatitis-e.
  8. Modrow M, Falke D, Truyen U, Schatzl H. Hepatitis E. Molecular virology. Springer Heidelberg New York Dordrecht London, 2013: 248-54.
  9. Gorbanian B, Saberi Y. Changes in Fetuin-B and RBP4 During A Course of High-Intensity Interval Training in Women with Nonalcoholic Fatty Liver. J Babol Univ Medical Sci. 2021; 23: 398-404.doi:10. 22088/jbums.23.1.398.
  10. Hepatitis E fact sheet.2024.https://www.who.int/news-room/fact-sheets/detail/hepatitis-e.
  11. Wang B, Meng XJ. Structural and molecular biology of hepatitis E virus. Computational and structural biotechnology journal. 2021 Jan 1;19:1907-16. doi.org/10.1016/j.csbj.2021.03.038.
  12. Emerson SU, Purcell RH. Hepatitis E viruse in: knipe DM, Howley PM, editors. Fields virology. 6 th ed.Philadelphia, PA: Lippincott Williams & Wilkins, a Welters Kluwer business, 2013: 2242-58.
  13. Kim JH, Nelson KE, Panzner U, Kasture Y, Labrique AB, Wierzba TF. A systematic review of the epidemiology of hepatitis E virus in Africa. BMC Infect Dis 2014; 14: 308. doi: 10.1186/1471-2334-14-308.
  14. Li TC, Ami Y, Suzaki Y, Yasuda SP, Yoshimatsu K, Arikawa J, Takeda N, Takaji W.     Characterization of full genome of rat hepatitis E virus strain from Vietnam. Emer Infect Dis. 2013; 19(1):115-8. doi: 10.3201/eid1901.121007.
  15. Behrooz Ataei1, Maryam Keihani2, Morteza Pourahmad3, Shahram Taheri. The Frequency of Hepatitis E in Renal Transplant Recipients in Isfahan City, Iran, on the Basis of Molecular Evaluation. ournal of Isfahan Medical School 2017; 35(448): 1283-88. (Persian)
  16. Taremi M, Gachkar L, MahmoudArabi S, Kheradpezhouh M, Khoshbaten M. Prevalence of antibodies to hepatitis E virus among male blood donors in Tabriz, Islamic Republic of Iran. East Mediterr Health J 2007; 13(1): 98-102. PMID: 17546911.
  17. Sotoodeh JA, Pourahmad M. Hepatitis E virus and serum level aminotransferases in blood donors. Rep Biochem Mol Biol 2013; 2(1): 48-51. MAG: 2279613927.
  18. Esmaeilzadeh A, Ganji A, Bahari A, Goshayeshi L. Prevalence of hepatitis E in Iran: a systematic review of the literature. Reviews in Clinical Medicine. 2017;4(4):152-9. doi.org/10.22038/rcm.2017.20169.1187.
  19. Smith DB, Simmonds P, International Committee on Taxonomy of Viruses Hepeviridae Study, G, Jameel S, Emerson SU, Harrison TJ, Meng XJ, Okamoto H, Van der Poel WH, Purdy MA . Consensus proposals for classification of the family Hepeviridae. J Gen Virol 2015; 95:2223-2232.doi: 10.1099/vir.0.068429-0.
  20. Wang Y, Ling R, Erker JC, Zhang H, Li H, Desai S, Mushahwar IK, and Harrison TJ. A divergent genotype of hepatitis E virus in Chinese patients with acute hepatitis. J G Virol. 1999; 80:169-177.doi: 10.1099/0022-1317-80-1-169.
  21. Ahmed A, Ali IA, Ghazal H, Fazili J, Nusrat S. Mystery of hepatitis e virus: recent advances in its diagnosis and management. Int J Hepatol 2015; 2015: 872431.doi: 10.1155/2015/872431.
  22. Bineshian F, Dalvand N, Hosseini SM, Sharifi Z. Hepatitis E Virus Infection Among Iranian Patients with Beta-Thalassemia. Middle East Journal of Rehabilitation and Health Studies. 2020;7(3). doi.org/10.5812/mejrh.101784.
  23. Slavov SN, Maçonetto JD, Martinez EZ, Silva‐Pinto AC, Covas DT, Eis‐Hübinger AM, Kashima S. Prevalence of hepatitis E virus infection in multiple transfused Brazilian patients with thalassemia and sickle cell disease. Journal of medical virology. 2019; 91(9):1693-7.doi: 10.1002/jmv.25498.
  24. Dalvand N, Dalvand A, Sharifi Z, Hosseini SM. Prevalence of hepatitis E virus in thalassemia patients with hepatitis C in Tehran, Iran. Iranian Journal of Microbiology. 2019; 11(6):535.doi: 10.18502/ijm.v11i6.2226.
  25. Abdelmawla D, Moemen D, Darwish A, Mowafy W. Hepatitis E virus prevalence in Egyptian children with transfusion-dependent thalassemia. Brazilian Journal of Infectious Diseases. 2019; 23(1):40-4.doi: 10.1016/j.bjid.2019.01.007.
  26. Tehmtan A, Moradi A, Ghaemi A, Klishadi M, Ghafari H, Hashemi P, Tabarai A. Seroepidemiology of Hepatitis E Virus in Hemodialysis Patients in Gorgan-Iran. MLJ. 2013; 7(2): 15-20.doi: 10.15171/mejdd.2016.31.
  27. Ataei B, Nokhodian Z, Javadi AA, Kassaian N, Shoaei P, Farajzadegan Z, et al. Hepatitis E virus in Isfahan Province: a population-based study. Int J Infect Dis 2009; 13(1): 67-71.doi: 10.1016/j.ijid.2008.03.030.
  28. Assarehzadegan MA, Shakerinejad G, Amini A, Rezaee SA. Seroprevalence of hepatitis E virus in blood donors in Khuzestan Province, southwest Iran. Int J Infect Dis 2008; 12(4): 387-90.doi: 10.1016/j.ijid.2007.09.015.
  29. ollmer T, Diekmann J, Johne R, Eberhardt M, Knabbe C, and Dreier J. Novel approach for detection of hepatitis E virus infection in German blood donors. J Clin Microbiol. 2012; 50(8):2708-13.doi: 10.1128/jcm.01119-12.
  30. Gallian P, Couchouron A, Dupont I, Fabra C, Piquet Y, Djoudi R, Assal A,Tiberghien P. Comparison of hepatitis E virus nucleic acid test screening platforms and RNA prevalence in French blood donors. Transfusion. 2017; 57(1):223-4.doi: 10.1111/trf.13889.
  31. Lot E, Hogema BM, Riezebos-Brilman A, Kok TM, Molier M, Zaaijer HL. Silent hepatitis E virus infection in Dutch blood donors, 2011 to 2012. EuroSurveill. 2013; 18(31).doi: 10.2807/1560-7917.es2013.18.31.20550.
  32. Hewitt PE, Ijaz S, Brailsford SR, Brett R, Dicks S, Haywood B, Kennedy IT,Kitchen A, Patel P, Poh J, Russell K, Tettmar KI, Tossell J, Ushiro-Lumb I,Tedder RS. Hepatitis E virus in blood components: a prevalence andtransmission study in Southeast England. Lancet. 2014; 384(9956):1766-73. doi: 10.1016/S0140-6736(14)61034-5.
  33. Auleda S, Ong E, Bes M, Janssen A, Cory R, Babizki M, Shin T, Lindquist A,Hoang A, Vang L, Piron M, Casamitjana N, Koppelman M, Danzig L, LinnenJM. Seroprevalence of hepatitis E virus (HEV) and detection of HEV RNAwith a transcription-mediated amplification assay in blood donors fromCatalonia (Spain). Transfusion. 2015;55(5):972-9. doi: 10.1111/trf.12929.
  34. Parsa R, Adibzadeh S, Behzad BA, Farhadi A,Yaghobi R, Rafiei Dehbidi GR, et al. Detection of Hepatitis E Virus Genotype 1 Among Blood Donors From Southwest of Iran. Hepat Mon 2016; 16(6):e34202.doi: 10.5812/hepatmon.34202.
  35. Aggarwal R, Naik S. Epidemiology of hepatitis E: current status. J Gastroenterol Hepatol 2009; 24(9):1484-93. 10.1111/j.1440-1746.2009.05933.x.
  36. Sharifipour S, Rad KD. Seroprevalence of hepatitis E virus among different age groups in Tehran, Iran. New Microbes and New Infections. 2020 1;34:100638