{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:37:22Z","timestamp":1782488242266,"version":"3.54.5"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Fundamental Fund of Khon Kaen University","award":["FF2569 KKU"],"award-info":[{"award-number":["FF2569 KKU"]}]},{"name":"the Health System Research Institute","award":["HSRI 68-049"],"award-info":[{"award-number":["HSRI 68-049"]}]},{"name":"Mahasarakham University Development Funds","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Many globin chain variants were interpreted as \u03b2-thalassemia or hereditary persistence of fetal hemoglobin (HPFH) at routine investigation. We described this in a large cohort of Thai subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Hematological data of 43,414 subjects encountered at our thalassemia diagnostic center from January 2013 to July 2025 were reviewed. A total of 372 subjects with hemoglobin (Hb) variants were selectively recruited with leftover DNA specimens for further analysis. Hb analysis was done using high-performance liquid chromatography (HPLC) or capillary electrophoresis. \u03b2-globin gene mutations were identified using PCR and related techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 372 subjects recruited, a total of 21 different Hb variants were found. The levels of Hb A\n                      <jats:sub>2<\/jats:sub>\n                      , Hb F, Hb variants, and DNA diagnostic requests were recorded. Hb variants with normal Hb A\n                      <jats:sub>2<\/jats:sub>\n                      and Hb F levels were requested for \u03b2-thalassemia or HPFH in 12.3% (95% CI\u2009=\u20097.9\u201316.8). This error was increased in Hb variants with Hb A\n                      <jats:sub>2<\/jats:sub>\n                      \u2009\u2265\u20093.6% [50.6% (95% CI\u2009=\u200939.8\u201361.4) and odds ratio of 7.3 (3.6\u201313.8)] and Hb F\u2009\u2265\u20095.0% [52.2% (95% CI\u2009=\u200937.7\u201366.6) and odds ratio of 7.8 (3.6\u201316.7)], especially in those with Hb A\n                      <jats:sub>2<\/jats:sub>\n                      \u2009\u2265\u20093.6% and Hb F\u2009\u2265\u20095.0% [71.9% (95% CI\u2009=\u200956.3\u201387.5) and odds ratio of 18.2 (7.1\u201348.9)]. Hbs Hope, Tak, Cook, C, Lepore, and Q-Thailand were found to be associated with high proportions of the error.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Hb variants with increased Hb A\n                      <jats:sub>2<\/jats:sub>\n                      levels and\/or co-migration with Hb F are associated with a high proportion of mis-interpretation of \u03b2-thalassemia in routine practice. Combining Hb analysis using two different methods, and molecular analysis should help improve laboratory interpretation of the cases.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0346729","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T17:24:56Z","timestamp":1776446696000},"page":"e0346729","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Common hemoglobin variants affecting the diagnosis of \u03b2-thalassemia: A large cohort data at a single 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