Madam, Beta thalassaemia major is a common genetic disorder in the country and hepatitis B and C viruses are prevalent in the blood donors population. therefore, patients with beta thalassaemia major who receive blood transfusions regularly to maintain optimal Hb level frequently suffer from the hepatitis infection. An earlier study has shown 51% prevalence of hepatitis C infection among them1. Screening of blood for HBs Ag reduces the risk of transmission, but could not eliminate it entirely, because of window period and low titre HBV infections, with HBV variants2. Recently, we screened 100 beta thalassaemia major patients for HBs Ag who were receiving blood from a voluntary blood transfusion service which arranges blood from family and voluntary donors and claims of providing screened blood to the patients. Out of 100 beta thalassaemia major patients screened, 22 appeared repeatedly reactive on ELISA (Auszyme Abbott Laboratories). It is not possible to rule out the possibility of transfusion of un-screened blood during their long course of treatments or use of some less sensitive test kits. This high prevalence ofHBV infection among beta thalassaemia major patients requires more stringent measure to select low risk voluntaiy blood donor, and use of more sensitive diagnostic kits. It is also necessary to vaccinate all beta thalassaemia major patients for hepatitis B infection as soon as they are diagnosed. Monitoring of anti HBs titre in the vaccinated population willbe helpful in assessing the risk of infection and identifying the need and time of a booster dose. Technical support of Abbott Diagnostic Division in conducting this study is appreciated.
Syed Abdul Mujeeb and Mubashir Ahrned Shiekh
Blood Transfusion Service, Jinnah Postgraduate Medical Centre, Karachi.
1. Mujeeb, SA., Khanani, MR., Jamal, Q. et at Prevalence of HCV among beta thalassaenia major patients. Tropical Doctor (accepted 13.1 1 1995).
2. Rasenack, J.W.F,. Schlayer, H,. Hettler. F et al. Hepatitis B virus infection without immunological markers after open heart surgery. Lancet, 1995;345:355-357.