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- Samimi-Rad, K., et al.
(author)
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Patient-to-Patient Transmission of Hepatitis C at Iranian Thalassemia Centers Shown by Genetic Characterization of Viral Strains
- 2013
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In: Hepatitis Monthly. - : Briefland. - 1735-143X .- 1735-3408. ; 13:1
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Journal article (peer-reviewed)abstract
- Background: Hepatitis C is prevalent among thalassemia patients in Iran. It is mainly transfusion mediated, in particular among patients treated before 1996 when blood screening was introduced. Objectives: The current study aimed to investigate why patients still seroconvert to anti-HCV in Iranian thalassemia centers. Patients and Methods: During 2006-2007 sera were sampled from 217 anti-HCV positive thalassemia patients at nine thalassemia centers in Tehran and Amol city, where 34 (16%) patients had been infected after 1996. The HCV subtype could be determined by sequencing and .NCR-core region in 130 strains׳5 phylogenetic analysis of partial NS5B and/or Results: 1a (53%) was predominant followed by 3a (30%), 1b (15%), and one strain each of 2k, 3k and 4a. Phylogenetic analysis revealed 19 clades with up to ve strains diverging with less than six nucleotides from each other within subtypes 1a and 3a. Strains in seven cla des were from nine patients infected between 1999 and 2005 and similar to strains from eight patients infected before 1996, indicating ongoin g transmission at the centers. Further epidemiological investigation revealed that 28 patients infected with strains within the same clade had frequently been transfused at the same shift sitting on the same bed. An additional eight patients with related strains had frequently bee n transfused simultaneously in the same room. Conclusions: The results suggest nosocomial transmission at these thalassemia centers both before and after the introduction of blood screening. Further training of sta and strict adherence to preventive measures are thus essential to reduce the incidence of new HCV infections.
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