Screening of beta-thalassemia major patients below 18 years for acute cytomegalovirus infection by IgM serology in Mosul

Aws H. Al-Numan¹, Salih Abed Mohammed², Ghazwan Y. Al-Shamaa³

¹Department of Pediatrics, College of Medicine, University of Mosul, Iraq - ²Assistant professor, Tikrit University Medical College, Pediatric Department, Tikri, Iraq - ³Pediatric Neurologist, Ibn-Sina Teaching Hospital, Mosul, Iraq

Introduction: Patients with beta-thalassemia major have a weakened immune system, making them vulnerable to transfusion related infections like cytomegalovirus (CMV), which can have serious consequences, particularly for those undergoing stem cell transplantation. So, screening these Patients for CMV using IgM serology and determining the factors which enhance the acquisition of this virus are crucial.   

Materials and methods: This cross-sectional study was performed on six hundred thirty-three thalassemia patients below 18 years in Mosul (North of Iraq). The fully automated immunoassay was used to detect the presence of IgM antibodies against cytomegalovirus as a mark to determine transfusion-transmitted active infection. In addition, six hundred forty-two healthy children and adolescent under 18 years were analyzed as a comparison group. The Chi-square test was used to ascertain statistical significance, while the odd ratio and likelihood ratio were used to evaluate the magnitude of the correlation between certain elements and the procuration of CMV infection.

Results: 12.79 per cent of patients with thalassemia were positive for active infection with cytomegalovirus compared to 4.36 per cent of the healthy non-thalassemia group. The key factors linked to an increase in infection rate are splenectomy, high ferritin, and repeated transfusions. No statistical significance has been established with respect to age, sex and residence in relation to CMV infection.

Conclusion: In comparison to other countries, there is a critical high incidence of cytomegalovirus infection among thalassemia patients; thus, steps to minimize this rate should be adopted.