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Abstract

A GENOTYPIC STUDY OF SEN VIRUS INFECTION IN HEALTHY BLOOD DONORS AND THALASSEMIA PATIENTS: WITH OR WITHOUT HCV INFECTION AND ITS CLINICAL IMPORTANCE

Author(s): BASHAR M. KHAZAAL*┬╣, ARWA H. AL-HAMDANI┬▓, ASHNA J. FAEQ

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 patient’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 16.8±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 16.7±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 withage 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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