Sero-molecular markers study prevalence on the virus (hepatitis C, B, Cytomegalovirus, and Toxoplasma gondii) among multi-transfused thalassemia among Iraqi people\wasit city

Thalassaemia is an inherited disease transmitted between individuals through genes. So far, no treatment other than genetic modification has been proven. Most patients receiving thalassaemia transfusions complain of disease transmission through the blood of donors. This study emphasises the necessity of molecular diagnosis, which is more effective and accurate than immunological and serological tests. In this context, our study aimed to investigate the prevalence of viruses (hepatitis C and B, Cytomegalovirus and Toxoplasma gondii) among thalassaemia patients transferred to the Iraqi population by sero-molecular markers after the collection of samples and the study of molecular serological markers were completed. The study included 500 beta-thalassaemia major patients. 67% of the patients were male, 33% were female and the age range was 5±50 years. ELISA was used to detect IgG and IgM and PCR test was used to determine the amount of virus in the serum samples of the patients participating in the study. According to available commercial ELISA and PCR kits, 16 samples (9 males, 7 females) carrying Hepatitis B and HBVsAg IgG and 7 samples (4 males, 3 females) carrying Hepatitis B and HBVsAg IgM were detected. HBV-PCR was positive in 5 patients (3 males, 2 females) and all control results were negative in 144 non-viral thalassaemia patients. Hepatitis C type HCVAb IgG was positive in 46 patients (27 males, 19 females). HCVAb IgM was positive in 26 patients, 16 males and 10 females. In PCR examination, 20 patients, 12 males and 8 females, were found positive. The results were also negative in the samples of thalassaemia patients. CMV-IgG was positive in 267 of 317 patients, of whom 139 were female and 128 were male. In the control group, IgG was positive in 60 males and 70 females. Cytomegalovirus IgM was positive in 47 patients, 17 and 30 in males and females, respectively. CMV-IgM was found positive by molecular markers in 28 individuals, 12 females and 16 males. Toxoplasmosis IgG was positive in 40 patients, 18 in males and 22 in females, while it was positive in 3 males and 3 females in thalassaemia patients without infection. In addition, Toxoplasma gondii IgM and PCR test results were negative in all patients and controls. According to these results, it was found that there is a significant difference between the two techniques, immunological and molecular diagnosis, and that it is not possible to rely on immunological diagnosis because immunoglobulins can remain for a long time, but the presence of antigens is an indicator for infection. Similarly, infection differed between men and women, and overall women were less infected, but Cytomegalovirus infection had higher values in women. As most infections occur through repeated blood transfusions, confirmation of molecular diagnosis of donor blood is recommended. Investigation of other pathogens should also be considered for donors as well as thalassaemia patients.