CD40LG and hepatitis A virus infection: In recent study, thalassemia patients may represent the convalescent phase of a previous exposure and potentially able to cause transfusion associated hepatitis E. The presence of patients with double positive antibodies (Ig-M and Ig-G), who ALT levels were higher than HEV single negative subjects indicated that HEV-associated hepatitis due to transfusion transmission may be occur but cannot be deduced from the higher levels of double antibodies and high ALT levels.