Prevalence of Hepatitis B, Hepatitis C and HIV in Sickle Cell Disease Patients from Oman

Background and Purpose: Oman is a country with an intermediate prevalence of Hepatitis B (HBV) carriers (2.8-7.1%, 2010¹), while the prevalence of HBV infection was 5.8% (2014²). Hepatitis C (HCV) prevalence reported from Oman was 0.41% (2016³). Further, a total of 2394 Human Immunodeficiency (HIV) infections were identified among Omanis (2013⁴). Unfortunately, there are no studies on the prevalence of HIV, HBV and HCV in sickle cell disease (SCD) patients from Oman.

Objectives: This study was therefore performed to estimate the prevalence of HBV, HCV and HIV among SCD patients from Oman.

Methods: In a retrospective cross-sectional cohort study, medical records of all patients with SCD and sickle cell trait (SCT) patients who received blood transfusions between 2006 to 2017 were retrieved from the hospital information system. Specifically, data on HIV, HBV and HCV exposure were recorded to study the prevalence, following approval for the study from the hospital medical research and ethics committee.

Results: Amongst a total of 1000 patient (491 males and 509 females), 126 (12.6%) had anti-HCV antibodies (anti-HCV) based on serology and amongst these 52(5.2%) were PCR positive. Genotype 1 was the most predominant (n=36), followed by genotype 3& 4(n=7 each) followed by genotype 2(n=2). 23 (2.3%) SCD patients showed positive serology for hepatitis B surface antigen (HbsAg) and amongst these 16 (1.6%) were PCR positive. None of the SCD patients showed positive serology for HIV. Liver Ultrasound was normal in 788 patients (78.8%), whereas, 208(20.8%) had hepatomegaly and 4(0.4%)had liver cirrhosis. Further, only 2 patients amongst the 36 patients who had died had a hepatic cause.

Conclusion: This study provides comprehensive data on the prevalence of HBV and HCV infection among SCD patients and raises concerns regarding the HCV prevalence in these patients with its impact on chronic liver disease. Reassuringly, no case with HIV was observed.