Hepatitis C virus (HCV) infection among patients with sickle cell disease at the Korle-Bu teaching hospital

Abstract

Background: Hepatitis C virus (HCV) infection is a blood borne infection that remains potentially transmissible through blood transfusions. Sickle cell disease (SCD) is a common inheritable haemoglobinopathy in Ghana that requires multiple blood transfusions as part of its management. The SCD patient is therefore at a high risk of HCV infection; however, data on the occurrence of HCV in SCD patients has not been documented in Ghana. This study sought to determine the prevalence and genotypes of HCV infection in SCD patients.

Materials and methods: This was a cross-sectional study which enrolled 141 sickle-cell disease patients from the Ghana Institute for Clinical Genetics, Korle-Bu Teaching Hospital (KBTH). Patient information was obtained through a structured questionnaire. Aliquots of the plasma obtained was used for both serology with Advanced Quality Rapid Anti-HCV Test Strip and molecular testing by RT-PCR with primers targeting the HCV core gene. The amplified DNA were purified and subjected to phylogenetic analysis to characterize HCV genotypes.

Results: Twelve (9%) out of the 141 patients were sero-positive for HCV total antibodies. HCV RNA was amplified from 8 (6%) out of the total number of patients' samples. One of the 12 sero-positives was HCV RNA positive. Five (63%) out of the 8 HCV RNA positive samples were successfully sequenced. The phylogenetic tree constructed with the study and GenBank reference sequences, clustered all five study sequences into HCV genotype 1.

Conclusion: The HCV seroprevalence of 9% among sickle cell disease patients is higher than reported for the general Ghanaian population which is 3%. Genotype 1 is the common HCV genotype infecting SCD patients. Sickle cell disease is likely to be a high-risk group for HCV inapparent infections in Ghana as seroprevalence does not correlate with viremia. However, even with higher seroprevalence, the group must be given priority in resource allocation for preventive, diagnostic and therapeutic strategies.

Keywords: Genotypes; HCV infection; Hepatitis C; Prevalence; Sickle cell anemia.

Fig. 1

Distribution of the number of blood transfusion in SCD patients by: A Gender distribution: The number of times of blood transfusion in participants against sex. B Age group distribution: The number of times of blood transfusion in participants against age groups in years. C Sickling group: The number of times of blood transfusion in participants against sickling status

Fig. 2

Relationship between the serologic and molecular testing. Red circle indicates the 12 patients who were HCV seropositive. The green circle indicates the total number of patients who were HCV RNA positive. One patient was positive by serology and PCR

Fig. 3

Phylogenetic relationship between HCV core sequences. Key: Samples from this study are in red font