The Epidemiological Characteristics of Hepatitis C Virus Among Patients with Inherited Bleeding Disorders

Abstract

Background: Patients who frequently receive blood and or blood products have high risk of hepatitis C virus (HCV) infection.Objectives: To evaluate the prevalence of (HCV) infection and determine potential risk factors among patients with inherited bleeding disorders.Patients and Methods: Across sectional retrospective study was conducted in the Hemophilia unit in Children Welfare Teaching Hospital, Medical city in Baghdad; between 1^st of Juneof2014 to 1^stof January of 2015. The medical records of 1158 patients with hemophilia A& B, von Willebrand disease (vWD), thrombosthenia, factors VII, X, XIII deficiencies and hypofibrinogenemia; of all ages were analyzed for the presence of HCV antibody using (ELISA) and for HBs antigen as co-infection.Results: The overall prevalence of HCV infection was (13.2%). Of total, 595 (51.4%) patients had hemophilia A and 99 (16.6%) were anti-HCV positive, while 225 (19.4%) had hemophilia B and 28 (12.4%) were antibody positive compared to 9 (7%) in vWD. Co infection of HBV was only found in hemophilia A with a prevalence of0.5%.Of those with hemophilia A, 515 (86.6%) had severe hemophilia. Thirty two(32.32%) cases of hemophilia A had acquired HCV infection after 1996 (after introduction of HCV screening in blood banks in Iraq) and there was a statistically significant association with treatment by factor VIII only. Conclusions: The prevalence of HCV in patients with inherited bleeding disorder is (13.2%). Since no independent risk factor was found in this high risk group, it can be concluded that multitransfusion is the only predictor for HCV infection. Anti-HCV antibody positivity was associated with the age at diagnosis of hemophilia, type of treatment and presence of inhibitory antibodies but not with the type of hemophilia, the severity of the disease nor positivity to HBV.

Keywords: Hepatitis C virus, hemophilia, bleeding disorders.