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. This evidence concerns the gene GPT and thalassemia.