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Ibrahim UA, Ahmed SG. Pathophysiology of bleeding diathesis in haemophilia-A: A sequential and critical appraisal of non-FVIII related haemostatic dysfunctions and their therapeutic implications. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2018. [DOI: 10.1016/j.ejmhg.2018.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Ibrahim UA, Ahmed SG. Determinants and modifiers of bleeding phenotypes in haemophilia-A: General and tropical perspectives. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2018. [DOI: 10.1016/j.ejmhg.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Angelotta C, McKoy JM, Fisher MJ, Buffie CG, Barfi K, Ramsey G, Frohlich L, Bennett CL. Legal, financial, and public health consequences of transfusion-transmitted hepatitis C virus in persons with haemophilia. Vox Sang 2007; 93:159-65. [PMID: 17683360 DOI: 10.1111/j.1423-0410.2007.00941.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND Since the first cases of acquired immunodeficiency syndrome in persons with haemophilia were reported in 1982, much has been written about the consequences of human immunodeficiency virus (HIV) contamination of the blood supply. Relatively little attention has been paid to similar hepatitis C virus (HCV) concerns since the first cases of HCV-infected persons with haemophilia were identified in 1989. METHODS We review the history, public health, policy, and financial consequences of blood supply policy decisions made for persons with haemophilia who received HCV-contaminated blood products in eight countries that were severely impacted by viral contamination of the blood supply during the 1980s, contrasting these findings with those reported previously for HIV contamination of the blood supply during the same time-period. A Medline search and a hand search of retrieved bibliographies of English-language articles on HCV concerns in haemophilia patients published from 1989 to 2006 were performed. RESULTS Our review identified that two- to eightfold more persons with haemophilia in the eight countries contracted HCV vs. HIV from contaminated blood products during the 1980s. Opportunistic infections and immunosuppression-related complications among persons with haemophilia developed shortly after these patients received HIV-infected blood products whereas hepatic complications among HCV-infected persons with haemophilia are just now being diagnosed two decades after these individuals received HCV-contaminated blood products. Policy makers in four countries conducted official public inquiries into blood safety decisions related to HIV- and/or HCV-contamination of the blood supply. More than 20 countries allocated compensation funds for HIV-infected persons with haemophilia (mean award ranging from $37 000 to 400 000) whereas only the UK, Canada, and Ireland allocated compensation funds for HCV-infected persons with haemophilia (mean award ranging from $37 000 to 50 000). CONCLUSION While the clinical impact among persons with haemophilia of HCV contamination of the blood supply in the 1980s was larger than the impact of HIV contamination of the blood supply during this time-period, the policy response was smaller. Consideration should be given to adopting support programmes for HCV-infected persons with haemophilia in countries that do not have these programs.
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Affiliation(s)
- C Angelotta
- Division of Hematology/Oncology, Department of Medicine, Northwestern University, Chicago, IL 60611, USA
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4
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Balabaud-Pichon V, Freys G, Faradji A, Wolf P, Pottecher T. [Liver transplantation in a patient with hemophilia A and end stage liver failure]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2001; 20:552-5. [PMID: 11471503 DOI: 10.1016/s0750-7658(01)00423-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We report the case of a 50 year-old man factor VIII deficient haemophiliac and hepatitis C cirrhosis. The patient underwent orthotopic liver transplantation because of episodes of variceal bleeding and encephalopathy. He received factor VIII replacement therapy perioperatively. Factor VIII returned to normal within 24 hours postoperatively and factor VIII replacement was stopped. Liver transplantation can be considered as definitive therapy for haemophilia.
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Affiliation(s)
- V Balabaud-Pichon
- Département d'anesthésie-réanimation chirurgicale, hôpitaux universitaires de Strasbourg, hôpital civil, 1, place de l'Hôpital, 67000 Strasbourg, France
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He L, Terunuma H, Hanabusa H, Iwamoto A, Oka S, Tanabe F, Chiba N, Kurimoto M, Ikeda M, Okamura H, Dai J, Iwatani Y, Ishida T, Ito M. Interleukin 18 and interleukin 1beta production is decreased in HIV type 1-seropositive hemophiliacs but not in HIV type 1-seropositive nonhemophiliacs. AIDS Res Hum Retroviruses 2000; 16:345-53. [PMID: 10716372 DOI: 10.1089/088922200309223] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In Japan, the proportion of hemophiliacs infected with human immunodeficiency virus type 1 (HIV-1) is 40%, whereas more than 90% are infected with hepatitis C virus (HCV). To evaluate the immunological status of hemophiliacs infected with HIV-1, we investigated the pattern of cytokine production in peripheral blood mononuclear cells (PBMCs) of HIV-1-seropositive and -seronegative hemophiliacs, HIV-1-seropositive non-hemophiliacs, and healthy individuals. The production of IL-18 and IL-1beta from PBMCs stimulated with Staphylococcus aureus Cowan strain 1 (SAC) in the HIV-1-seropositive hemophiliacs was significantly decreased in comparison with the other groups. On the other hand, IL-12 production in both HIV-1-seropositive groups was significantly lower than in HIV-1-seronegative groups. TNF-alpha and IL-6 production was similar among the four groups. In contrast, plasma levels of TGF-beta1 were increased in HIV-1-seropositive hemophiliacs, HIV-1-seropositive nonhemophiliacs, and HIV-1-seronegative hemophiliacs, with the highest levels being in HIV-1-seropositive hemophiliacs, suggesting that coinfection with HIV-1 and HCV increases the level of plasma TGF-beta in HIV-1-seropositive hemophiliacs. Treatment of PBMCs from healthy individuals with TGF-beta1 inhibited IL-18 and IL-1beta production without affecting IL-6, IL-10, or TNF-alpha production. Suppression of the expression of caspase 1 mRNA, which is known to be an IL-1beta-converting enzyme and which also cleaves the precursor of IL-18, was observed in the SAC-stimulated PBMCs from healthy individuals after treatment with TGF-beta1 and in the SAC-stimulated PBMCs from HIV-1-seropositive hemophiliacs, suggesting that the decreased production of IL-18 and IL-1beta in HIV-1-seropositive hemophiliacs may be related to the downregulation of caspase 1 mRNA induced by high levels of TGF-beta1 in plasma.
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Affiliation(s)
- L He
- Department of Microbiology, Yamanashi Medical University, Japan
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6
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Takayama S, Miura T, Matsuo S, Taki M, Sugii S. Prevalence and persistence of a novel DNA TT virus (TTV) infection in Japanese haemophiliacs. Br J Haematol 1999; 104:626-9. [PMID: 10086806 DOI: 10.1046/j.1365-2141.1999.01207.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
To clarify the clinical implication of a newly discovered 'TT virus (TTV)', we assayed TTV DNA in sera from 50 haemophiliacs by a seminested-PCR. TTV DNA was detected in 75% (35/50), which was a much higher prevalence than for HBV (HBc-Ab), HCV RNA, or HGV RNA. In particular, TTV DNA was found in 44.4% (4/8) of patients who had been treated only with virally inactivated factor VIII concentrates. Elevated ALT levels were observed in patients with HCV RNA and TTV DNA; however, the elevation in TTV DNA was obtained from patients co-infected with HCV RNA (62.9%, 22/35). There was no significant difference in ALT levels between TTV DNA-positive and DNA-negative in patients without HCV RNA. 85.3% (35/41) of TTV DNA-positive sera in 1990 were again positive for TTV DNA in 1995. These findings suggest that many haemophiliacs have been infected with TTV. Although TTV infection was not associated with serum ALT elevation, persistent TTV infection may contribute to cryptogenic hepatic failure in haemophiliacs.
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Affiliation(s)
- S Takayama
- Division of Laboratory Research, St Marianna University-Yokohamashi Seibu Hospital, Yokohama, Japan.
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7
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Brodie SB, Keller MJ, Ewenstein BM, Sax PE. Variation in incidence of indinavir-associated nephrolithiasis among HIV-positive patients. AIDS 1998; 12:2433-7. [PMID: 9875581 DOI: 10.1097/00002030-199818000-00012] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nephrolithiasis may be an important consequence of indinavir therapy; however little has been published on the variation in incidence between different populations of patients or the possible mechanisms of calculus formation. OBJECTIVE To examine variation in the incidence of indinavir-associated nephrolithiasis (IAN) in HIV-positive patients in relation to hemophilia and hepatitis C virus (HCV) infection. METHODS Clinical data were abstracted retrospectively from the medical records of all adult patients treated with indinavir from September 1995 to September 1997. Occurrence of first IAN, defined as flank pain and hematuria after initiation of therapy, was analyzed in relation to hemophilia status and HCV infection. RESULTS There were 17 episodes of IAN (22%) among 79 patients treated with indinavir. Of 10 patients with hemophilia, 50% developed IAN as compared with 17% of patients without hemophilia (P = 0.03). Median days to first IAN was 22 (range 7-110 days) for hemophiliacs and 156 (range 5-611 days) for those without hemophilia. Data for HCV status were available for 74 out of 79 patients: 10 out of 27 (37%) patients with HCV developed IAN compared with six out of 42 (14%) without HCV (P = 0.02). CONCLUSION Overall incidence of IAN was higher than that previously reported and was significantly greater in hemophiliacs than in non-hemophiliacs. HCV may be a contributing factor.
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Affiliation(s)
- S B Brodie
- Division of Infectious Disease, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Abstract
This analysis evaluated the extent to which infections with selected blood-borne viruses, specifically infection with hepatitis B virus, hepatitis C virus, and/or the human immunodeficiency virus (HIV), continue to contribute to the morbidity of persons with hemophilia. The Georgia Hemophilia Surveillance System collected information on 336 state residents with hemophilia A or B who were followed by a physician in 1994. Data abstracted from medical records included information on demographics, sources of hemophilia care, clinical characteristics, joint range of motion measurements, hospitalization, and results of laboratory testing for hepatitis B, hepatitis C, and the human immunodeficiency virus. Prevalence of infection with one or more of these viruses was determined, and relationships with disease severity, bleeding frequency, and amount of clotting factor prescribed were explored. No child under the age of ten was positive for the human immunodeficiency virus; hepatitis infection was also uncommon in this age group, in contrast to the very high frequency of such infections among older subjects. There was a strong association between HIV positive status and infection with one of the hepatitis viruses. The likelihood of all types of viral infection increased with frequency of bleeding and with amount of clotting factor received. Efforts to prevent transmission of lipid-enveloped viruses via clotting factor have been extremely effective. However, currently infected hemophilia patients will likely experience significant morbidity and mortality due to chronic liver disease and AIDS-related complications.
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Affiliation(s)
- H A Hill
- Department of Epidemiology, Rollins School of Public Health of Emory University, Atlanta, Georgia 30322, USA.
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Abstract
The world-wide prevalence of hepatitis C virus (HCV) is approximately 1%. Being primarily a blood-borne virus, the major risk factors for HCV include the receipt of blood and blood products, as well as intravenous drug use. As a result, many individuals infected with HIV are also infected with HCV. Any effect of coinfection on progression of either HIV or HCV is likely to have a tremendous impact on the mortality and morbidity of these individuals and should be considered when managing coinfected individuals. This review will describe the epidemiology and clinical manifestations of HCV and will consider the evidence for an impact of coinfection on the progression of both viruses.
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Affiliation(s)
- C A Sabin
- Department of Primary Care and Population Sciences, Royal Free Hospital and School of Medicine, London, England
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Miura T, Meguro T, Takayama S, Yamada K. Interferon therapy for Japanese hemophiliacs with chronic hepatitis C. ACTA PAEDIATRICA JAPONICA : OVERSEAS EDITION 1997; 39:556-8. [PMID: 9363652 DOI: 10.1111/j.1442-200x.1997.tb03640.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Eight Japanese hemophiliacs with chronic hepatitis C (CHC) received interferon (IFN) therapy and four of them (50%) responded completely. Non-responders included 3 double-infected patients: 1 with hepatitis B virus (HBV) and 2 with human immunodeficiency virus-1 (HIV-1). In one of the patients with HIV-1 double infection, the absolute number of CD4+ lymphocytes decreased during IFN therapy. These findings suggest that hemophiliac patients with CHC can respond well to IFN therapy, but in patients who are double-infected with HBV and HIV-1, the indication of IFN therapy should be considered seriously.
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Affiliation(s)
- T Miura
- Department of Pediatrics, Haga Red Cross Hospital, Tochigi, Japan
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11
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Carter TL, Cole CH, Mews CF, Price PJ, Baker DL. The prevalence of hepatitis C in survivors of paediatric malignancy. J Paediatr Child Health 1997; 33:238-41. [PMID: 9259300 DOI: 10.1111/j.1440-1754.1997.tb01587.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To assess the prevalence of hepatitis C in 200 patients with paediatric malignancies, surviving in remission more than 5 years from diagnosis, who had received blood product transfusions before 1990 when routine screening of blood products for hepatitis C began. METHOD The second and third generation Abbott Diagnostics ELISA was used to assess hepatitis C seropositivity. Seropositive patients and those with abnormal liver transaminases were assessed by hepatitis C virus RNA polymerase chain reaction (PCR). RESULTS A low incidence (4%) of seropositivity for hepatitis C was found in survivors of paediatric malignancy who were transfused prior to routine screening of blood products in this cohort. CONCLUSIONS All patients identified have evidence of hepatitis and may be at high risk of developing cirrhosis.
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Affiliation(s)
- T L Carter
- Haematology/Oncology Department, Princess Margaret Hospital for Children, Subiaco, Western Australia
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Goeser T, Seipp S, Wahl R, Müller HM, Stremmel W, Theilmann L. Clinical presentation of GB-C virus infection in drug abusers with chronic hepatitis C. J Hepatol 1997; 26:498-502. [PMID: 9075655 DOI: 10.1016/s0168-8278(97)80413-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS Recently, the hepatitis GB-C virus (GBV-C) has been identified as another virus potentially causing chronic hepatitis. Although high rates of coinfection are emerging in drug addicts with chronic hepatitis C virus infection, no detailed data on clinical presentation are available. Therefore, co-infection was sought in hepatitis C virus patients to determine the impact of GB-C virus on clinical presentation. METHODS GBV-C was determined by nested reverse transcriptase-polymerase chain reaction in serum of 70 HIV negative intravenous drug abusers with chronic hepatitis C. Biochemical, histological and virological parameters were compared between patients with or without GBV-C coinfection. RESULTS Hepatitis C virus and GBV-C coinfection was found in 18 of 70 (25.7%) patients. Cases with coinfection were younger and had shorter duration of disease (31.4+/-6.2 vs. 35.3+/-7.3 (p=0.09) and 9.9+/-6.8 vs. 12.9+/-7.7 (p=0.17) years) than those without coinfection. Neither hepatitis C virus genotype distribution and HCV RNA levels nor serum liver function tests, titers of immunoglobulins or autoantibodies differed between the two groups. Histologically, chronic active hepatitis (16.7 vs. 46.4%, p=0.07), fibrosis (8.3% vs. 21.4%, p=0.3), and cirrhosis (0% vs. 8.2%, p=0.31) were less prevalent in coinfected patients. After interferon treatment, 5/6 coinfected and 11/19 patients with hepatitis C virus infection alone had cleared HCV RNA and 4/6 lost GBV-C RNA from serum. The two patients with GBV-C/HCV infection who persistently cleared hepatitis C virus but not GBV-C from serum had normal transaminases during follow-up despite persistence of GBV-C. CONCLUSIONS Coinfection of chronic hepatitis C patients with GBV-C does not lead to a significant change in clinical presentation, severity of liver disease, hepatitis C viremia, or response to interferon treatment.
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MESH Headings
- Adult
- Alanine Transaminase/blood
- Antibodies, Antinuclear/analysis
- Antiviral Agents/therapeutic use
- Chronic Disease
- DNA Primers/chemistry
- Enzyme-Linked Immunosorbent Assay
- Female
- Flaviviridae/genetics
- Flaviviridae/immunology
- Follow-Up Studies
- Genotype
- Hepacivirus/genetics
- Hepacivirus/immunology
- Hepatitis C/complications
- Hepatitis C/pathology
- Hepatitis C/therapy
- Hepatitis C Antibodies/analysis
- Hepatitis, Viral, Human/complications
- Hepatitis, Viral, Human/pathology
- Hepatitis, Viral, Human/therapy
- Humans
- Interferon-alpha/therapeutic use
- Male
- Polymerase Chain Reaction
- RNA, Viral/analysis
- Retrospective Studies
- Substance Abuse, Intravenous/blood
- Substance Abuse, Intravenous/complications
- Substance Abuse, Intravenous/virology
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Affiliation(s)
- T Goeser
- Department of Internal Medicine, University of Heidelberg, Germany
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VanAken WG. The potential impact of recombinant factor VIII on hemophilia care and the demand for blood and blood products. Transfus Med Rev 1997; 11:6-14. [PMID: 9031486 DOI: 10.1016/s0887-7963(97)80005-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- W G VanAken
- Central Laboratory of The Netherlands Red Cross Blood Transfusion Service, Amsterdam, The Netherlands
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Aguilar C, Lucía JF. Is liver biopsy really necessary in haemophiliacs with chronic hepatitis C? Haemophilia 1996; 2:260-1. [PMID: 27214370 DOI: 10.1111/j.1365-2516.1996.tb00150.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C Aguilar
- Haemostasis Unit, Department of Haematology, Hospital Miguel Servet, Zaragoza, Spain
| | - J F Lucía
- Haemostasis Unit, Department of Haematology, Hospital Miguel Servet, Zaragoza, Spain
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Dasani H, Evely R, Hampton KK, Sabah AA. Hepatocellular failure from hepatitis C infection in two recipients of a single batch infusion of plasma-derived blood products. Haemophilia 1996; 2:177-179. [PMID: 27214113 DOI: 10.1111/j.1365-2516.1996.tb00163.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report two patients with mild inherited bleeding disorders who acquired hepatitis C infection after receiving single infusion of plasma-derived concentrates prior to the introduction of donor screening and viral inactivation procedures. Both these patients became clinically jaundiced at the time of hepatitis C infection. Despite being HIV antibody negative, an absence of other risk factors of chronic liver disease and treatment with interferon, they progressed to hepatocellular failure in 5 and 12 years following seroconversion. The natural history of hepatitis C infection is still uncertain [1], although it is usually considered that hepatitis C infection progresses slowly, only resulting in clinically manifest liver disease after several decades. In view of the apparent rapidity of onset of liver damage in these two patients, we wonder if older age at time of infection, jaundice during the seroconversion illness or a mild coagulopathy with consequent infrequent exposure to blood products are adverse prognostic features.
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Affiliation(s)
- H Dasani
- Arthur Bloom Centre, University Hospital of Wales, CardiffDepartment of Haematology, University Hospital of Wales, Cardiff
| | - R Evely
- Arthur Bloom Centre, University Hospital of Wales, CardiffDepartment of Haematology, University Hospital of Wales, Cardiff
| | - K K Hampton
- Arthur Bloom Centre, University Hospital of Wales, CardiffDepartment of Haematology, University Hospital of Wales, Cardiff
| | - A A Sabah
- Arthur Bloom Centre, University Hospital of Wales, CardiffDepartment of Haematology, University Hospital of Wales, Cardiff
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GORINGE A, AL-SABAH A, DASANI H. A lesson from persistently elevated aspartate transaminases (AST) in a patient with severe haemophilia A. Haemophilia 1996; 2:114-5. [DOI: 10.1111/j.1365-2516.1996.tb00026.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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HAGIWARA T, FUKUE H, KAWATA K, YAMAGISHI T, YAMAMOTO Y, ARAI M, FUKUTAKE K. Beta interferon therapy for chronic hepatitis C in patients with haemophilia and other haemorrhagic disorders. Haemophilia 1996; 2:104-8. [DOI: 10.1111/j.1365-2516.1996.tb00024.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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PRESTON FE, DUSHEIKO G, LEE CA, LUDLAM CA, GIANGRANDE PLF. Guidelines on the diagnosis and management of chronic liver disease in haemophilia. Haemophilia 1995; 1 Suppl 4:42-4. [DOI: 10.1111/j.1365-2516.1995.tb00133.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chambost H, Gerolami V, Halfon P, Thuret I, Michel G, Sicardi F, Rousseau S, Perrimond H, Cartouzou G. Persistent hepatitis C virus RNA replication in haemophiliacs: role of co-infection with human immunodeficiency virus. Br J Haematol 1995; 91:703-7. [PMID: 8555079 DOI: 10.1111/j.1365-2141.1995.tb05372.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In order to evaluate the evolution of transfusional hepatitis C in haemophiliacs, we performed a retrospective study of ALT levels and HCV viraemia with a RNA PCR assay in 57 patients. We found that the vast majority of HCV-infected patients remained viraemic (43/57 = 75%) and higher ALT levels correlated with HCV viraemia. Although indicators of the transfusional viral load (age, severity of haemophilia) and HBV co-infection did not correlate with HCV RNA replication, HIV seropositivity was strongly associated with persistence of HCV viraemia (23/25 = 92% in HIV-positive versus 20/32 = 62% in HIV-negative patients), without any correlation with CD4 counts. Genotyping of HCV in the 43 viraemic patients shows more frequent genotype 1 in the HIV-seropositive group (14/23) than in the seronegative group (6/20). Our data emphasize that besides the role of the immunodeficiency status, the genotypes of HCV might be involved in the differences observed in terms of HCV RNA replication between the HIV-seropositive and seronegative haemophiliacs.
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Affiliation(s)
- H Chambost
- Service d'Hématologie Pédiatrique, CHU Timone, Marseille, France
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