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Singh A, Rawat S, Kushwaha R, Jain M, Verma SP, Singh US. Clinicopathological Parameters of Haemophilia Patients at a Tertiary Care Centre in Northern India. Cureus 2023; 15:e41670. [PMID: 37575728 PMCID: PMC10412897 DOI: 10.7759/cureus.41670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2023] [Indexed: 08/15/2023] Open
Abstract
INTRODUCTION Haemophilia affects a large number of people all over the world, yet very little is known about the clinical manifestations and diagnostic protocols of the condition in areas with limited access to resources in developing countries. Understanding the clinical spectrum and diagnostic approach will help with the design of measures to address the situation in these places. The primary objective of this study was to examine the clinicopathological parameters of haemophiliac patients. MATERIALS AND METHODS From the departmental archive, a thorough history of each patient was retrieved, including values of bleeding time, prothrombin time, activated partial prothrombin time, and percentage of specific factor activity. RESULTS Out of a total of 385 cases over the period of six years, 86.75% were classified as haemophilia A and 13.25% of cases were diagnosed as haemophilia B. In terms of the severity of the disease, 44.93% were classified as severe, 42.08% as moderate, and 12.99% as mild. Joint bleeding was the first and most typical clinical manifestation of the disease, accounting for 34.80% of cases, followed by ecchymosis (23.12%), post-traumatic bleeding (12.73%), epistaxis (12.20%), and gum bleeding (8.05%). 1.56% of patients had a positive screening test for the hepatitis C virus, followed by 1.30% for HIV and 0.78% for hepatitis B surface antigen. CONCLUSION In the presence of joint bleeding, ecchymosis, and post-traumatic bleeding in an otherwise healthy individual, a clinician should be alerted to the possibility that the patient has haemophilia and should request a work-up for the bleeding disorder.
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Affiliation(s)
- Anurag Singh
- Pathology, King George's Medical University, Lucknow, IND
| | - Shalini Rawat
- Pathology, King George's Medical University, Lucknow, IND
| | | | - Mili Jain
- Pathology, King George's Medical University, Lucknow, IND
| | | | - U S Singh
- Pathology, King George's Medical University, Lucknow, IND
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Hasan M, Lal J, Ali N. Frequency and types of transfusion reactions in pediatric population: A report from a tertiary care center in Pakistan. IRAQI JOURNAL OF HEMATOLOGY 2022. [DOI: 10.4103/ijh.ijh_47_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Peng HM, Wang LC, Zhai JL, Weng XS, Fen B, Wang W. Transfusion-transmitted infections in hemophilia patients who underwent surgical treatment: a study from a single center in north China. Arch Med Sci 2020; 16:308-312. [PMID: 32190141 PMCID: PMC7069421 DOI: 10.5114/aoms.2020.92892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 09/12/2017] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Transfusion-transmitted infections (TTIs) continue to be a major challenge among hemophilia patients. This study was conducted to investigate the prevalence of TTIs including hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and syphilis in patients with hemophilia who received surgical treatment due to bone or joint lesions in the Department of Orthopedics. MATERIAL AND METHODS The present study was conducted from July 1996 to November 2016 in Beijing, China. A total of 189 patients who underwent orthopedic procedures were enrolled. Blood samples were obtained from the patients and were tested for hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (HCV Ab) and human immunodeficiency virus antibody (HIV Ab). RESULTS Among 189 hemophilia patients included in the study, 54 (28.6%) tested positive for TTI. Seroprevalence for HBsAg was found in 8 (4.2%) cases, HCV Ab in 48 (25.4%) cases, HIV Ab in 2 (1.1%) cases, and syphilis in 1 (0.5%) case. No statistically significant difference in the numbers of patients with positive HCV Ab was seen between hemophilia A (26.0%) and B (20.0%) (p = 0.786). The seroprevalence of HCV Ab (12.1%) in 66 hemophilia patients diagnosed after 1995 was significantly lower than that (32.5%) among hemophilia patients diagnosed before or in 1995 (p = 0.003). CONCLUSIONS Though few patients have become positive for HBsAg and HIV Ab, HCV is still the major virus of concern for hemophiliacs who have undergone orthopedic procedures. Hepatitis B vaccination should be given to the high-risk population including hemophilia patients as soon as possible.
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Affiliation(s)
- Hui-Ming Peng
- Department of Orthopedic Surgery, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Long-Chao Wang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ji-Liang Zhai
- Department of Orthopedic Surgery, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xi-Sheng Weng
- Department of Orthopedic Surgery, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Bin Fen
- Department of Orthopedic Surgery, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Wang
- Department of Orthopedic Surgery, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Kadhim KAR, Al-Lami FH, Baldawi KH. Epidemiological Profile of Hemophilia in Baghdad-Iraq. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 56:46958019845280. [PMID: 31081421 PMCID: PMC6537227 DOI: 10.1177/0046958019845280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Hemophilia is an inherited bleeding disorder that mainly affects males. Globally,
there are about 400 000 people with hemophilia and only 25% of them receive
adequate treatment. There is insufficient epidemiological data on hemophilia in
Iraq; so, this study was conducted to determine the trend of the prevalence and
incidence and to identify certain clinical and epidemiological characteristics
of patients with hemophilia in Baghdad, Iraq, 2016. This cross-sectional study
was conducted in the 4 hemophilia centers in Baghdad. The data were compiled by
reviewing all hemophilia patients’ records and the centers’ registry books
between 2007 and 2016. Corresponding population data of Baghdad were obtained
from the Ministry of Health. The total number of currently registered patients
who are residents of Baghdad was 654. The prevalence of hemophilia increased
from 7.2/100 000 males in 2007 to 15.9/100 000 males in 2016. Similarly, the
incidence of hemophilia had increased from 8.4/100 000 livebirths in 2007 to
16.3/100 000 livebirths in 2016. Severe hemophilia represented 63.4% of all
types. The prevalence of hepatitis C virus (HCV), hepatitis B virus (HBV), and
HIV infections were 22.9%, 0.9%, and 0.2%, respectively. Clotting factor
inhibitors were positive in 11.6% and target joints were found among 45.1% of
patients. About 27% were on prophylactic therapy. Only one death was recorded in
2016. The prevalence and incidence of hemophilia in Baghdad was doubled in
10-year period. The prevalence of different complications was almost close to
the rates in the neighboring countries.
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Mousavi SH, Khairkhah N, Bahri TD, Anvar A, Saraji AA, Behnava B, Alavian SM, Namvar A. First Report of Prevalence of Blood-Borne Viruses (HBV, HCV, HIV, HTLV-1 and Parvovirus B19) Among Hemophilia Patients in Afghanistan. Sci Rep 2019; 9:7259. [PMID: 31086199 PMCID: PMC6513844 DOI: 10.1038/s41598-019-43541-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 04/26/2019] [Indexed: 12/13/2022] Open
Abstract
Blood-borne viruses including Hepatitis B and C, HIV, HTLV-1 and parvovirus B19 are still a factor of concern, especially for hemophilia patients. Although the safety of the blood supply continues to improve worldwide, the blood supply system in Afghanistan was damaged by many years of conflict and political instability. To date, there are few studies focused on the prevalence of blood-borne viruses in hemophilia patients. This study is first to investigate the prevalence of five blood-borne viruses in Afghanistan hemophilia patients in four cities including Kabul, Herat, Mazar-i-Sharif and Jalal Abad. A total of 80 hemophilia male patients were screening for the presence of five transfusion-transmitted viruses using ELISA and PCR. Data obtained showed 2.5% seropositivity for HBV, 8.75% seropositivity for HCV, and 91.25% seropositivity for parvovirus B19. None of the patients were positive for HIV and HTLV-1 and the prevalence of HCV was higher in older patients rather than younger patients. This finding, the first to report in Afghanistan, shows a high prevalence of parvovirus B19 in Afghanistan hemophilia patients and implementation of highly sensitive screening is necessary.
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Affiliation(s)
- Sayed Hamid Mousavi
- Department of the Biochemistry, Faculty of medicine, Kateb University, Kabul, Afghanistan.,Afghanistan National Charity organization for Special Diseases (ANCOSD), Kabul, Afghanistan
| | - Niloofar Khairkhah
- Molecular Diagnostic Divisions, Iranian Comprehensive Hemophilia Care Center, Tehran, Iran.,Department of Molecular Medicine, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Tina Delsouz Bahri
- Molecular Diagnostic Divisions, Iranian Comprehensive Hemophilia Care Center, Tehran, Iran.,Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Anvar
- Molecular Diagnostic Divisions, Iranian Comprehensive Hemophilia Care Center, Tehran, Iran
| | - Alireza Azizi Saraji
- Molecular Diagnostic Divisions, Iranian Comprehensive Hemophilia Care Center, Tehran, Iran
| | - Bita Behnava
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Moayed Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ali Namvar
- Molecular Diagnostic Divisions, Iranian Comprehensive Hemophilia Care Center, Tehran, Iran.
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Al Kanaani Z, Mahmud S, Kouyoumjian SP, Abu-Raddad LJ. The epidemiology of hepatitis C virus in Pakistan: systematic review and meta-analyses. ROYAL SOCIETY OPEN SCIENCE 2018; 5:180257. [PMID: 29765698 PMCID: PMC5936963 DOI: 10.1098/rsos.180257] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 03/13/2018] [Indexed: 05/06/2023]
Abstract
To characterize hepatitis C virus (HCV) epidemiology in Pakistan and estimate the pooled mean HCV antibody prevalence in different risk populations, we systematically reviewed all available records of HCV incidence and/or prevalence from 1989 to 2016, as informed by the Cochrane Collaboration Handbook. This systematic review was reported following the PRISMA guidelines. Populations were classified into six categories based on the risk of exposure to HCV infection. Meta-analyses were performed using DerSimonian and Laird random-effects models with inverse variance weighting. The search identified one HCV incidence study and 341 prevalence measures/strata. Meta-analyses estimated the pooled mean HCV prevalence at 6.2% among the general population, 34.5% among high-risk clinical populations, 12.8% among populations at intermediate risk, 16.9% among special clinical populations, 55.9% among populations with liver-related conditions and 53.6% among people who inject drugs. Most reported risk factors in analytical epidemiologic studies related to healthcare procedures. Pakistan is enduring an HCV epidemic of historical proportions-one in every 20 Pakistanis is infected. HCV plays a major role in liver disease burden in this country, and HCV prevalence is high in all-risk populations. Most transmission appears to be driven by healthcare procedures. HCV treatment and prevention must become a national priority.
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Affiliation(s)
- Zaina Al Kanaani
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
| | - Sarwat Mahmud
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
| | - Silva P. Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Qatar Foundation - Education City, PO Box 24144, Doha, Qatar
- Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, NY, USA
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Ali M, Nadeem M, Numan M, Khalil AT, Maqbool K, Yousaf MZ, Shinwari ZK, Idrees M. Thirty years of HIV in Pakistan: a systematic review of prevalence and current scenario. Future Virol 2017. [DOI: 10.2217/fvl-2017-0009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: HIV infection was first reported in Pakistan in 1987. Since then it has been a point of concern in the country. Materials & methods: We searched the literature on HIV in Pakistan using different keywords in Google, Pubmed, PakMediNet and GoogleScholar, and found a total of 64 articles dating from 1987 to 2016. Results: Total 4,882,450 individuals from Pakistan have been screened for HIV since last 30 years. The estimated overall prevalence was 0.041% (95% CI: 0.0–6.79). The highest infection rates of 15.05% (SE = 4.27%) were observed in injection drug users, followed by refugees (2.63%), sex workers (2.21%) and prisoners (1.32%). Conclusion: Awareness and medical surveillance programs in the high-risk population are required to decrease future burden of HIV in Pakistan.
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Affiliation(s)
- Muhammad Ali
- Department of Biotechnology, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Muhammad Nadeem
- Department of Biotechnology, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Muhammad Numan
- Department of Biotechnology, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Ali Talha Khalil
- Department of Biotechnology, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Khurram Maqbool
- National Center for Bioinformatics, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Muhammad Zubair Yousaf
- Centers of Excellence in Science & Applied Technologies, Islamabad, Pakistan
- Department of Biological Sciences, Forman Christian College (A Chartered University), Lahore, 54600 Pakistan
| | - Zabta Khan Shinwari
- Department of Biotechnology, Quaid-i-Azam University, Islamabad, 45320 Pakistan
| | - Muhammad Idrees
- Hazara University Mansehra, Khyber Pakhtunkhwa, 21120 Pakistan-
- Center for Applied Molecular Biology (CAMB), University of the Punjab, 53700 Lahore
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Varaklioti A, Kouramba A, Ioannidou P, Katsarou O. Occult hepatitis B virus infection in Greek patients with congenital bleeding disorders. INFECTION GENETICS AND EVOLUTION 2017; 54:397-401. [PMID: 28705716 DOI: 10.1016/j.meegid.2017.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 06/20/2017] [Accepted: 07/09/2017] [Indexed: 01/04/2023]
Abstract
Occult Hepatitis B Infection (OBI) is a form of chronic HBV infection characterized by low level HBV DNA, without detectable HBV surface antigen (HBsAg). OBI is frequently associated with the presence of anti-HBc and in some cases also with anti-HBs. Patients, who formerly received non-inactivated factor concentrates, can potentially be considered at high risk for OBI, especially since these patients usually are HIV or HCV co-infected. This study aimed to assess the prevalence of occult HBV infection in Greek patients with hereditary bleeding disorders. The study sample comprised of 114 patients from a single haemophilia center. All patients were screened for HBV serum markers and individually tested for HBV DNA using a qualitative PCR. Presence of HBV DNA was further confirmed by quantification of viral load with an ultrasensitive in-house real time PCR. 88 and 21 patients with haemophilia A and B, respectively, 4 patients with von Willebrand Disease and 1 patient with severe factor VII deficiency were screened for the presence of OBI. Anti-HBc were detected in 53 (46.5%) subjects; 18 of them were anti-HBs(-) and 35 anti-HBs(+). Anti-HBe were present in 26 subjects. Two out of 114 patients were HBsAg(+). Of the remaining 112 HBsAg(-) patients tested, two (1.8%) were found HBsAg(-), HBV DNA(+), anti-HBc(+) and anti-HBs(-) and were identified as potential OBI cases. Both cases exhibited very low DNA levels; 38.2IU/mL in patient A and 14.2IU/mL in patient B. Both patients were HBeAg(-), but patient A had HBe antibodies. Patient B was also HIV/HCV co-infected. In conclusion, two cases of OBI with low HBV viraemia were identified among patients with congenital bleeding disorders. Although the incidence in our sample is moderately low (1.8%), close monitoring of these infections is of great clinical significance, especially in patients with co-infections and concomitant immunosuppression.
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Affiliation(s)
- Agoritsa Varaklioti
- Blood Center and National Reference Center for Congenital Bleeding Disorders, Laiko General Hospital, Agiou Thoma 17, 11527 Athens, Greece; Faculty of Social Sciences, Department of Health Management, Hellenic Open University, Patras, Greece
| | - Anna Kouramba
- Blood Center and National Reference Center for Congenital Bleeding Disorders, Laiko General Hospital, Agiou Thoma 17, 11527 Athens, Greece
| | - Panagiota Ioannidou
- Blood Center and National Reference Center for Congenital Bleeding Disorders, Laiko General Hospital, Agiou Thoma 17, 11527 Athens, Greece
| | - Olga Katsarou
- Blood Center and National Reference Center for Congenital Bleeding Disorders, Laiko General Hospital, Agiou Thoma 17, 11527 Athens, Greece.
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Afzal MS. Hepatitis C Virus and Interferon-Free Antiviral Therapeutics Revolution: Implications for Pakistan. Viral Immunol 2017; 30:252-257. [PMID: 28118096 DOI: 10.1089/vim.2016.0164] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Hepatitis C virus (HCV) is a major health concern worldwide as a leading cause of liver-related mortalities and morbidities. Pakistan ranks second among countries with endemic HCV infection; ∼11 million cases are reported so far. HCV burden is continuously rising in Pakistan, mainly because of unsafe blood transfusions, surgical procedures, dental procedures, untrained clinicians, reuse of syringes, barbers, and ear/nose piercing tools. Lack of awareness about HCV transmission routes among the general and high-risk population is a major hurdle in disease management. HCV prevalence in the general population and healthy blood donors ranges from 3.13% to 23.83% and from 1.05% to 20.8%, respectively; whereas in the high-risk groups, HCV prevalence is up to 66%. Genotype 3 is most prevalent in Pakistan followed by genotypes 1 and 2 along with an alarming number of untypable viral genotypes in the local community. Mainly interferon-based antiviral regimens are used in Pakistan and are quite effective, because the major prevalent genotype (genotype 3) showed the best sustained virological response (SVR) with it. But a large number of individuals did not show SVR either because of infection with nonresponder genotypes or because of side effects. Due to these reasons, there was a need for interferon-free direct acting antivirals (DAAs). Recently, Sovaldi (Sofosbuvir: NS5B inhibitor) is approved on a heavy discounted rate for Pakistan; it is currently in effective use and showed good SVR. Sovaldi plus ribavirin is used alone or along with interferon to treat different viral genotypes. Sovaldi will be the future treatment regime for Pakistan, because genotype 2 and genotype 3 infected individuals achieve the best SVR with it. For the treatment of other prevalent viral genotypes, approval of some other DAAs such as Ledipasvir on discounted price is required for better disease management.
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Affiliation(s)
- Muhammad Sohail Afzal
- Department of Chemistry, School of Science, University of Management and Technology (UMT) , Lahore, Pakistan
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Jonaidi-Jafari N, Rezaee-Zavareh MS, Tavallaei-Nosratabadi J, Ajudani R, Ramezani-Binabaj M, Karimi-Sari H, Izadi M, Ranjbar R, Miri SM, Alavian SM. Occult Hepatitis B Infection in Hepatitis C Patients with Hematological Disorders. Jundishapur J Microbiol 2016; 10. [DOI: 10.5812/jjm.40816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
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Mirzaei J, Ziaee M, Farsad SA, Fereydooni M, Anani Sarab G, Rezvani Khorashad MR. Vaccination Against Hepatitis A for Hemophilic Patients: Is It Necessary? HEPATITIS MONTHLY 2016; 16:e37447. [PMID: 27257430 PMCID: PMC4888500 DOI: 10.5812/hepatmon.37447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 03/08/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hemophilic patients require long-life intravenous infusion of factor concentrates to treat bleedings. This could increase the risk of transmission of blood-borne infections like hepatitis C. OBJECTIVES The current study was aimed at investigating the immunity status against hepatitis A in hemophilic patients in south Khorasan and evaluating the necessity of hepatitis A vaccination for this population. PATIENTS AND METHODS A cross-sectional descriptive study was conducted between 2014 and 2015 on all hemophilic patients of south Khorasan province, Iran (n = 108) for anti-HAV total, anti- HCV, HBs-Ag, anti-HIV, and anti-HTLV-I /II. Note that no one had already received a hepatitis A vaccine. RESULTS As our results show, 77.8% of the participants (59% under 20 and 88.4% above 20 years old) were seropositive for anti-HAV total; 20.4% and 2.8% (three patients) of the cases were anti-HCV positive and anti-HTLV-1 positive, respectively, while none of the subjects were HBS-Ag or HIV-Ab positive. Seventeen of the patients (15.75%) showed a co-infection of HAV with HCV, and five HCV-infected patients (22.73%) had no immunity against hepatitis A. There was a significant relationship between age, rural life, and anti-HAV positive state in our patients (P < 0.001). No significant relationship between positive anti-HAV status and sex (P = 0.16), severity of hemophilia (P = 0.23), and infection with HIV, HCV, HTLV-1, and hepatitis B (P > 0.05) was detected. CONCLUSIONS More than 40% of the hemophilic patients under 20 years of age in the present study had no immunity against hepatitis A, and 23% of hepatitis C patients had not had a hepatitis A co-infection yet. Since hepatitis A can show a fulminant course in hepatitis C patients, vaccination against hepatitis A seems necessary in hemophilic patients in the region.
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Affiliation(s)
- Jamal Mirzaei
- Infectious Disease Research Center, AJA University of Medical Sciences, Tehran, IR Iran
| | - Masood Ziaee
- Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran
- Corresponding Author: Masood Ziaee, Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran. Tel: +98-5632443243; +98-9151613942, E-mail:
| | - Seyed Ali Farsad
- Infectious Disease Research Center, AJA University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Fereydooni
- Asthma, Allergy and Immunology Research Center, Birjand University of Medical Sciences, Birjand, IR Iran
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Umer M, Iqbal M. Hepatitis C virus prevalence and genotype distribution in Pakistan: Comprehensive review of recent data. World J Gastroenterol 2016; 22:1684-1700. [PMID: 26819533 PMCID: PMC4721999 DOI: 10.3748/wjg.v22.i4.1684] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 10/11/2015] [Accepted: 12/14/2015] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) is endemic in Pakistan and its burden is expected to increase in coming decades owing mainly to widespread use of unsafe medical procedures. The prevalence of HCV in Pakistan has previously been reviewed. However, the literature search conducted here revealed that at least 86 relevant studies have been produced since the publication of these systematic reviews. A revised updated analysis was therefore needed in order to integrate the fresh data. A systematic review of data published between 2010 and 2015 showed that HCV seroprevalence among the general adult Pakistani population is 6.8%, while active HCV infection was found in approximately 6% of the population. Studies included in this review have also shown extremely high HCV prevalence in rural and underdeveloped peri-urban areas (up to 25%), highlighting the need for an increased focus on this previously neglected socioeconomic stratum of the population. While a 2.45% seroprevalence among blood donors demands immediate measures to curtail the risk of transfusion transmitted HCV, a very high prevalence in patients attending hospitals with various non-liver disease related complaints (up to 30%) suggests a rise in the incidence of nosocomial HCV spread. HCV genotype 3a continues to be the most prevalent subtype infecting people in Pakistan (61.3%). However, recent years have witnessed an increase in the frequency of subtype 2a in certain geographical sub-regions within Pakistan. In Khyber Pakhtunkhwa and Sindh provinces, 2a was the second most prevalent genotype (17.3% and 11.3% respectively). While the changing frequency distribution of various genotypes demands an increased emphasis on research for novel therapeutic regimens, evidence of high nosocomial transmission calls for immediate measures aimed at ensuring safe medical practices.
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13
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Farrugia A, Hermans C, Franchini M. Assessing options for treating haemophilia with inhibitors. Haemophilia 2015; 21:307-309. [PMID: 25855015 DOI: 10.1111/hae.12676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2015] [Indexed: 01/01/2023]
Affiliation(s)
- A Farrugia
- Faculty of Medicine Surgery and Health Sciences, The University of Western Australia, Crawley, Western Australia
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14
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Fattahi MR, Safarpour A, Sepehrimanesh M, Hosseini Asl SMK, Mohamaddoust F. The prevalence of hepatitis C virus infection and its related risk factors among the rural population of fars province, southern iran. HEPATITIS MONTHLY 2015; 15:e24734. [PMID: 25788957 PMCID: PMC4350250 DOI: 10.5812/hepatmon.24734] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 12/01/2014] [Accepted: 01/17/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hepatitis C virus (HCV) infection is a major blood-borne infection with silent epidemic, major global public health problem and diverse prevalence worldwide. OBJECTIVES This study aimed to evaluate the prevalence of HCV infection and related risk factors in the general population of two villages, Farmashkan and Akbarabad, of the Kavar City in Fars Province, Iran. PATIENTS AND METHODS A 34-month cross-sectional study was performed on all people of the villages aged ≥ 7 years from July 2007 to April 2010. Demographic information and history of HCV-related risk factors were extracted from their medical records. For each participant, the serum anti-HCV IgG was assessed by the commercial enzyme-linked immunosorbent assay (ELISA) kits. RESULTS A total of 6095 participants (36.4% male and 65.6% female) with the mean age of 92 (7-95) and mean ± SD of 34.6 ± 17.3 years were included in this study. Fifteen persons (0.24%) were detected as HCV-positive and the highest prevalence was seen in age ≤ 12 years old (1%). A significant association was only detected between blood transfusion and HCV infection; therefore, those persons with history of blood transfusion had 15-fold higher risk for HCV seropositivity (odds ratio 15.54, 95% CI = 4.89-49.41). CONCLUSIONS Our reported rate of HCV seropositivity is similar to the previous Iranian reports. However, future evaluations should be focused on the Polymerase Chain Reaction method for the detection of HCV and determining and evaluating of other related risk factors. Moreover, more attention should be paid to blood donors as a reservoir population of HCV.
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Affiliation(s)
- Mohammad Reza Fattahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Alireza Safarpour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Masood Sepehrimanesh
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | | | - Faezeh Mohamaddoust
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
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15
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Valizadeh N, Nateghi S, Noroozi M, Hejazi S, Aghanezhad F, Ali AAM. Seroprevalence of hepatitis C, hepatitis B and HIV viruses in hemophiliacs born 1985-2010 in west Azarbaijan of Iran. Asian J Transfus Sci 2013; 7:55-8. [PMID: 23559767 PMCID: PMC3613664 DOI: 10.4103/0973-6247.106739] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Although, in the past the risk of transfusion transmitted viral infections were high in hemophilia patients, but introduction of viral inactivation methods in1985,decreased the risk of human immunodeficiency and hepatitis C and B viruses transmission significantly. The aim of study was seroprevalence of hepatitis B surface antigen (HBs Ag), hepatitis C virus antibody (HCV Ab) and human immunodeficiency virus antibody (HIVAb) in hemophiliacs in west Azarbaijan of Iran, born in 1985-2010. Materials and Methods: In a cross-sectional study, fifty patients with hereditary bleeding disorders born in 1985-2010, from total 250 patients who had been registered in Urmia Hemophilia Society were enrolled through the year 2010 to assess their seroprevalence for HCV Ab, HIV Ab and HBs Ag. Thirty five of 50 patients had hemophilia. Also; we performed a subset analysis for hemophilia patients. Results: All 50 patients with hereditary bleeding disorders including 35 patients with hemophilia were seronegative for HIV Ab and HBs Ag. HCV-Ab was detected in serum of 3 of 50 (6%) patients with bleeding disorders. After subset analysis for hemophilia (A and B) patients, we found HCV infection in 8.57% (3 of 35) of hemophiliacs. Conclusion: In this study prevalence of HCV infection was very smaller than similar studies in Iran and other countries. This study shows the safety of using viral inactivated factor concentrates and recombinant factors after year 1985. None of Hemophiliacs were seropositive for HIV Ab and HBs Ag.
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Affiliation(s)
- Nasim Valizadeh
- Department of Hematology & Medical Oncology, Emam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran
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Dubey A, Verma A, Elhence P, Agarwal P. Evaluation of transfusion-related complications along with estimation of inhibitors in patients with hemophilia: A pilot study from a single center. Asian J Transfus Sci 2013; 7:8-10. [PMID: 23559756 PMCID: PMC3613672 DOI: 10.4103/0973-6247.106714] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Apart from inhibitor development in patients with hemophilia (PWH) the old problems of blood borne viral infections and red cell alloimmunization still persist in PWH from developing countries. This study was planned to detect the presence of inhibitors in our PWH and to determine the presence of transfusion transmitted infections (TTI) markers and clinically significant red cell alloantibodies in these patients. Materials and Methods: One hundred fourteen PWH were screened for various laboratory tests. Screening for inhibitors was done by mixing study. Blood grouping, TTI testing and red cell alloantibody detection were done as per the departmental standard operating procedures. Results: Out of 114 patients evaluated 98(86%) had hemophilia A and remaining 16(14%) had hemophilia B. Five (5.1%) patients of hemophilia A were positive on inhibitor screening. On Bethesda assay, one patient was high responder (14.4 BU/ml) and rest 4 were low responders (<5 BU/ml). Overall, 19 PWH were positive for TTI markers and two had clinically significant red cell alloantibody (anti-E and anti-Jkb). Conclusion: This is probably first comprehensive study from our state on laboratory testing in PWH. The specialty of Transfusion Medicine can be a core part of hemophilia care. The overall prevalence of inhibitors in our hemophilia A patients was 5.1%, which is less as compared to majority of published studies.
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Affiliation(s)
- Anju Dubey
- Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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17
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Arababadi MK, Nasiri Ahmadabadi B, Yousefi Daredor H, Kennedy D. Epidemiology of occult hepatitis B infection among thalassemic, hemophilia, and hemodialysis patients. HEPATITIS MONTHLY 2012; 12:315-9. [PMID: 22783342 PMCID: PMC3389356 DOI: 10.5812/hepatmon.5934] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Revised: 09/28/2011] [Accepted: 04/24/2012] [Indexed: 12/11/2022]
Abstract
CONTEXT Hepatitis B virus (HBV) is the most common disease commuted through blood transfusion. Occult hepatitis B infection (OBI) is a form of the disease which does not present Hepatitis B surface antigens (HBsAg) in the serum of patients; however, HBV-DNA is detectable in the serum and hepatocytes of patients. OBI is an important risk factor to induce post transfusion hepatitis (PTH), cirrhosis, hepatocellular carcinoma (HCC) and reactivation of the HBV. Recently, several reports from various regions of the world have been published regarding PTH among blood recipients as well as HCC, and cirrhosis among patients who require permanent blood transfusion, including diseases such as hemophilia, hemodialysis and thalassemia. This form of the hepatitis also creates problems for individuals that are co-infected with other viruses such as HCV and HIV. To determine the prevalence of OBI among hemophilia, hemodialysis and thalassemia patients is important because it is a high risk factor for PTH, HCC and cirrhosis therefore, its detection is a critical strategy for most health care services. This review addresses recent information regarding prevalence of OBI in relation to the mentioned diseases. EVIDENCE ACQUISITION The data presented here was collected by searching the key words in Pubmed and Scopous databases. RESULTS Our searching in the published papers revealed that OBI prevalence is frequent in patients receiving frequent blood transfusions. CONCLUSIONS it seems that one of the main mechanisms for OBI transmission is most likely through infected blood and its component and evaluation of the prevalence of OBI in donors and patients, especially those with hemophilia and thalassemia should be foul considered.
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Affiliation(s)
- Mohammad Kazemi Arababadi
- Department of Microbiology, Hematology and Immunology, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran
- Corresponding author: Mohammad Kazemi Arababadi, Department of Microbiology and Immunology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran. Tel.: +98-39152340035, Fax: +98-3915225209, E-mail:
| | - Behzad Nasiri Ahmadabadi
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran
| | - Hassan Yousefi Daredor
- Department of Biochemistry, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran
| | - Derek Kennedy
- Schools of Biomolecular and Physical Science, Griffith University Nathan, Queensland, Australia
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