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LETTER TO THE EDITOR
Year : 2018  |  Volume : 21  |  Issue : 2  |  Page : 116

Prevalence of hepatitis B surface antigen in children with sickle cell anemia


Department of Haematology, UDUTH, Sokoto, Nigeria

Date of Web Publication6-Jul-2018

Correspondence Address:
Dr. Abubakar Umar Musa
Department of Haematology, UDUTH, Sokoto
Nigeria
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DOI: 10.4103/smj.smj_4_17

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How to cite this article:
Musa AU, Ndakotsu MA, Abubakar SB, AbdulQadir I. Prevalence of hepatitis B surface antigen in children with sickle cell anemia. Sahel Med J 2018;21:116

How to cite this URL:
Musa AU, Ndakotsu MA, Abubakar SB, AbdulQadir I. Prevalence of hepatitis B surface antigen in children with sickle cell anemia. Sahel Med J [serial online] 2018 [cited 2018 Nov 19];21:116. Available from: http://www.smjonline.org/text.asp?2018/21/2/116/236064



Sir,

The article titled, “Prevalence of Hepatitis B surface (HbS) antigen in children with sickle cell anemia” published in Sahel Medical Journal Vol. 17/issue 1/January–March 2014 left no doubt on the relevance of such a study in the management of hepatitis B viral (HBV) infection in sickle cell anemia (SCA) patients. Being a chronic hemolytic disorder, SCA predisposes affected patients to repeated blood transfusions with the attendant risk of transfusion transmissible infections including HBV infection as well as the risk of progression to chronic liver disease.

We however noted that hemoglobin electrophoresis (using cellulose acetate media) was employed for the confirmation of SCA among the study participants whose age ranged from 6 months to 15 years. We feel this method alone is inadequate and should also be discouraged.

The use of hemoglobin electrophoresis (using cellulose acetate media) for confirmation of sickle cell disorders (SCDs) may be fraught with false negativity due to low sensitivity to small amount of HbS as is usually encountered at the age of 6–9 months.[1] In addition, the co-migration of hemoglobins D and G alongside hemoglobin S may increase the chances of its false positivity in the diagnosis of SCDs.[1]

The algorithm provided by the Nigerian national guideline for the definitive laboratory diagnosis of SCD recommends that an unrelated second method should be employed for the confirmation of the diagnosis.[2] The first or screening method expected to be employed is the hemoglobin electrophoresis (except at the primary health-care levels/centers where facilities for such may not exist) and positive results must be followed up with peripheral blood film review, sickling or solubility testing for confirmation.[2] Further testing such as high-performance liquid chromatography, isoelectric focusing, and DNA analysis, if available, may be performed to differentiate between hemoglobinopathies.[2]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Brown BA. Special hematology procedures. In: Hematology: Principles and Procedures. 5th ed. Philadelphia: Lea and Febiger Publishers; 1988. p. 159-67.  Back to cited text no. 1
    
2.
National Guideline for the Control and Management of Sickle Cell Disease. Federal Ministry of Health Abuja Nigeria; 2014. p. 3-12.  Back to cited text no. 2
    




 

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