Prevalence and risk factors of hepatitis E virus infection among patients with β-thalassemia major in South of Iran

ABSTRACT This study was performed to determine the prevalence and risk factors of hepatitis E virus (HEV) infection among thalassemia patients. All β-thalassemia major patients on regular blood transfusion attending the blood transfusion centers located in southern Iran were invited to participate in this study. ELISA was used to detect anti-HEV IgM and anti-HEV IgG antibodies. The molecular detection of HEV infection was performed by nested RT-PCR assay, targeting the ORF2 region of HEV genome, and sequencing. In this study, 16.67% of thalassemia patients were positive for anti-HEV IgG compared to 12.1% of the controls. Thalassemia patients were negative for anti-HEV IgM and HEV viremia. Patients with blood transfusion every two weeks had significantly higher anti-HEV IgG seroprevalence compared to the patients with blood transfusions at longer intervals (OR: 12.50; 95% CI: 1.76–88.74; P = .012). Anti-HEV IgG seroprevalence was not statistically associated with age, gender distribution, ethnicity, place of residency, education level, and serum levels of liver enzymes. This study reports a high seroprevalence of HEV among thalassemia patients, while frequency of blood transfusion was significantly associated with anti-HEV IgG seropositivity. This suggests that frequent blood transfusion may be a risk factor for exposure to HEV infection among thalassemia patients.