Molecular diagnosis of HTLV-1 and HCV infection in polytransfused sickle cell disease in Kinshas: case of CMMASS

CONTEXT: Sickle cell patients present with permanent hemolytic anemia very often requiring transfusions. These transfusions put sickle cell patients at risk of HTLV-1 and HCV infection. OBJECTIVE: To determine the prevalence of HTLV-1 and HCV infection among polytransfused sickle cell patients in Kinshasa. METHODS: This is a cross-sectional study with a descriptive aim in polytransfused sickle cell patients followed at the SS Mixed Medicine Center for Anemia (CMMASS). The parameters of interest were age, gender, number of transfusions. Molecular diagnosis of HTLV-1 and HCV was carried out by conventional amplification. RESULTS: The median age of polytransfused sickle cell patients is 29 years. The female gender is in the majority 51.1% and the median number of transfusions is 24. A little over 11% of polytransfused sickle cell patients are infected with HCV, with a female predominance of 80%. Additionally, 60% of HCV-infected cases received between 2 and 19 transfusions. Approximately 5.5% of polytransfused sickle cell recipients are infected with HTLV-1, with the infection showing a female predominance of 80%. Most cases (80%) have received more than 20 transfusions. Coinfection with HCV and HTLV-1 occurs in about 2.2% of polytransfused sickle cell patients, representing 2/90 individuals. The 2 cases are female and are all aged 26. They received more than 20 transfusions at 80%. CONCLUSION: Polytransfused sickle cell patients are a population at risk for HCV (11.1%) and HTLV-1 (5.5%) infections. Hence the need to introduce molecular tests and leukoreduction into transfusion safety (leukoreduction doesn’t prevent HCV and HTLV transfusion transmission). CLINICAL TRIAL NUMBER: Not applicable.