PREVALENCE OF HEPATITIS C AMONG EGYPTIAN CHILDREN WITH SICKLE CELL DISEASE AND THE ROLE OF IL28B GENE POLYMORPHISMS IN SPONTANEOUS VIRAL CLEARANCE

Background and objectives: Hepatitis C virus (HCV) is a major health problem in Egypt with its prevalence estimated to be 14.7% among general population in 2008. Patients receiving frequent blood transfusions like sickle cell disease (SCD) are more exposed to the risk of acquiring HCV. IL28B gene polymorphisms have been associated with spontaneous HCV clearance. This study aims to determine the prevalence of HCV infection among children with SCD and to study the relation between IL28B gene polymorphisms and spontaneous HCV clearance. Methods: Seventy SCD patients were screened for HCV antibody. HCV positive patients were tested for the level of HCV RNA using quantitative real time PCR. IL28B polymorphisms (rs 12979860 SNP and rs 12980275 SNP) were detected using Taqman QRT-PCR and sequence specific primers PCR respectively. Results: Sixteen patients (23%) were HCV antibody positive, 9 of them (56.3%) had undetectable HCV RNA in serum and 7 (43.7%) had persistent viremia. Genotypes CC/CT/TT of rs12979860 were found in 30 (42.9%), 29 (41.4%) and 11 (15.7%) and rs12980275 AA/AG/GG were found in 8 (11.4%), 59 (84.3%) and 3 (4.3%).  There was no significant difference in the frequency of IL28B (rs 12979860 and rs12980275) genotypes among HCV patients who cleared the virus and those with persistent viremia (p=0.308 and 0.724 respectively).  Conclusion: Egyptian SCD patients have high prevalence of HCV. Muti-transfused patients still exposed to a risk of transmission of HCV. IL28B gene polymorphisms are not associated with spontaneous clearance of HCV in this cohort of Egyptian children with SCD

Oxidant-antioxidant status in Egyptian children with sickle cell anemia: a single center based study

OBJECTIVE:the present study was conducted to investigate the oxidant-antioxidant status in Egyptian children with sickle cell anemia.METHODS:the serum levels of total antioxidant capacity (TAO), paraoxonase (PON), vitamin E, nitrite, and malondialdehyde (MDA) were measured in 40 steady state children with homozygous sickle cell anemia (24 males and 16 females) and 20 apparently healthy age- and gender-matched controls.RESULTS:mean serum TAO, PON, vitamin E, and nitrite levels were significantly lower in the group with sickle cell anemia, whereas mean serum MDA was significantly higher in these children compared to controls. No significant differences in mean levels of TAO, PON, nitrite, vitamin E, and MDA were found in sickle cell anemia patients receiving hydroxyurea when compared with those not receiving hydroxyurea. A significant negative correlation between serum nitrite and the occurrence of vaso-occlusive crises (VOC) was observed (r = -0.3, p = 0.04). PON level was found to be positively correlated with patients' weight and BMI (r = -0.4, p = 0.01; r = -0.7, p < 0.001, respectively), but not with frequency of VOC. The area under the curve of serum nitrite in predicting occurrence of VOC was 0.782, versus 0.701 for PON, and 0.650 for TAO (p = 0.006). Serum MDA was not correlated with nitrite, PON, TAO, or vitamin E levels. No significant correlations were detected between serum nitrite and hemoglobin or antioxidant enzymes.CONCLUSION:children with sickle cell anemia have chronic oxidative stress that may result in increased VOC, and decreased serum nitrite may be associated with increases in VOC frequency. A novel finding in this study is the decrease in PON level in these patients, which is an interesting subject for further research