Risk factors for Hepatitis C virus antibody seropositivity among children with sickle cell anaemia in Ilorin, Nigeria

Abstract

Background: Hepatitis C is an infectious disease of the liver caused by the hepatitis C virus (HCV) resulting to a chronic hepatitis. Chronic HCV infection constitutes a serious public health challenge in Nigeria where donor blood is not routinely screened for HCV. Patients with sickle cell anaemia (SCA) are considered a subset of the population at higher
risk of acquiring the virus, due to their frequent needs for transfusion of blood and its products. Other risk factors like scarification markings, tattooing, and circumcision also predispose children to acquiring this infection. However, the magnitude of HCV infection has not been adequately measured in our general population and specific data on HCV in SCA patients are scanty, hence a prospective case controlled study to determine the risk factors that predispose to the acquisition of hepatitis C Virus infection.
Objective: To determine the risk factors for Hepatitis C Virus Antibody Seropositivity among transfused children with SCA in Ilorin.
Subjects and Method: Eighty two transfused SCA children aged 6 months to 14 years were recruited consecutively from February 2008 to January 2009 while eighty four non transfused SCA children of the same age range recruited over the same period served as controls. Hepatitis C virus Antibody screening was done using a second generation ELISA method. Information on the study population were collected by use of a pretested questionnaire by the investigator.
Results: There was a positive correlation between numbers of units of blood transfused and seropositivity. Those who had three or more units of blood had a prevalence rate of more than 50%. There was a strong correlation between seropositivity and scarification marks in both subjects and controls (p=0.001 and 0.02 respectively). Other plausible risk factors for hepatitis C infection tested in this study included circumcision and sharing of clippers which showed no statistically significant difference. No cases of tattooing, drug abuse, needle sharing or sexual activities were seen in this study.
Conclusion: Transfused SCA patients belong to a high risk group for hepatitis C virus infection compared to the nontransfused population. The risk of acquisition increases with higher number of transfusions and scarifications marks.

Key words: Hepatitis C virus, Sickle cell anaemia, Risk factors, Blood transfusion.