Evaluation of Lymphocyte Activation Gene 3 Activity with Hepatitis C Virus Infection in Beta Thalassemia Major Patients

Abstract

Background: An infection with the hepatitis C virus can be contracted directly through transfusions or indirectly through contaminated materials (unsafe injections and surgical procedures). The hepatitis C virus (HCV) is the cause of hepatitis C. When the virus gets beyond the host's innate and adaptive immune systems, 60–80% of people with acute hepatitis C go on to acquire the chronic form. Seven significant clades, known as genotypes 1–7, have been identified in the revised HCV categorization based on phylogenetic analysis of several nearly full-length genomes. 86 subcategories have been identified from these genotypes. Purpose: The goal is to study the association of immunological checkpoint activity of lymphocyte activation gene 3 (LAG3) in thalassemia patients infected with the Hepatitis C virus. Methods:  200 participants that was cross-sectional. 69 patients positive HCV and 131 negative participants their ages range between (2-49) years. The samples were collected using fresh blood and serum samples. The sample consisted of 106 females and 94 males in both the patient. Samples were gathered between November 1, 2024, and the end of January 2025.  from Center of Al-Batoul Hospital in Wasit, Kut Governorate, Iraq. The level of serum HCV (IgG-IgM) was employing an enzyme-linked immunosorbent assay (ELISA) to measure it. The enzyme-linked         immunosorbent assay (ELISA) was also used to evaluate immune checkpoint LAG3. Results: There is no statistically significant correlation between LAG-3 levels and any of the hematological parameters (WBC, lymphocytes, platelets, or hemoglobin) in the study, and LAG-3 levels do not substantially correlate with either age or sex (p >0.05). P-values are more than 0.05. There is no discernible relationship between HCV-specific humoral immune responses (IgG or IgM) and LAG-3 expression. P-values are more than 0.05. When comparing HCV-positive and HCV-negative patients, LAG-3 levels are noticeably higher in the former. The P-value < 0.001 indicates a highly significant, Although ROC analysis showed a significant association with HCV status (AUC = 0.662), its low specificity limits its standalone diagnostic utility. Conclusion: LAG-3 levels were significantly higher in HCV-positive thalassemia patients, but showed no association with hematological, demographic, or humoral immune parameters. Although linked to HCV status, its low specificity limits its diagnostic value.