A GENOTYPIC STUDY OF SEN VIRUS INFECTION IN HEALTHY BLOOD DONORS AND THALASSEMIA PATIENTS: WITH OR WITHOUT HCV INFECTION AND ITS CLINICAL IMPORTANCE
Background: SEN-Virus (SEN-V-D and SEN-V-H) is a DNA virus which associated with acute post transfusion hepatitis and blood transfusion is the most common mode of transmission of this virus like HCV, HBV and HIV among population. Beta thalassemia is a disease need continuous blood transfusions to manage the patientâ€™s life; so these patients are at increased risk of infection with SEN-V. Aims of this study: This study was designed to search the prevalence of SEN-V among thalassemia patients and blood donors and to evaluate the clinical importance of SEN-Virus in thalassemia patients with or without HCV infection in Iraq and to detect the exact genomic characterization of SEN-V-D and SEN-V-H genotypes in Iraq and study of similarity of these genomes with other countries especially the neighboring countries and the homology between each isolate. Methods: One hundred and fifty eight thalassemia patients (57.6% male, 42.4% female), with mean age of 16.8Â±8.5 year, and one hundred and fifty healthy blood donors with randomly selected persons (58.7%male, 41.3% female), with mean age of 16.7Â±8.6 year; all these samples involved in this study. SEN-V and HCV had been identified by nested conventional PCR. Liver transaminases (Aspartate Transaminase and Alanine Transaminase) had been determined, in addition of measure of serum ferritin levels by VIDAS. Gene sequencing and phylogenetic analysis had been studied of randomly selected amplified SEN-V D and H DNA samples. Results: SEN-V was detected in 68 from 158 (43%) of thalassemia patients and 16 from 150 (10.7%) of blood donors. HCV prevalence was (11.4%) in thalassemia patients. There was significant increase in prevalence of SEN-V or HCV infection with age but there was no significant difference in prevalence in both with gender. SEN-V and HCV co-infection significantly increases AST level above normal range. SEN-V significantly increases ALT level above normal range and has a great significant ALT level increase with HCV co-infection. Serum ferritin has no significant relation with SEN-V or SEN-V and HCV co-infection. The results from the study of gene sequencing and phylogenetic analysis of samples of amplified SEN-V-D DNA and samples of amplified SEN-V-H DNA that selected randomly from blood donors and thalassemia patients infected with D or H genotypes alone or together (co-infection) were concluded that the most transmission route of SEN-V D and H was blood transfusion, because there was (99%) gene similarity between blood donors and thalassemia patients, furthermore SEN-V-D or SEN-V-H sequences of the co-infected persons are the same sequences of D or H genotypes alone with the observations of similarity with other neighboring countries. Conclusion: SEN-V (D & H) can be transmitted via blood transfusion and cause acute hepatitis with or without HCV co-infection. The most countries had similar sequences to Iraqi SEN-V-D genotype sequence are Iran, USA and Brazil; while the most countries have similar sequences to Iraqi SEN-V-H genotype sequence are China and Iran. SEN-V-D or SEN-V-H sequences of the co-infected persons are the same sequences of D genotype or H genotype of persons that have infection with SEN-V-D or H alone.
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