Incidence of infection with hepatitis B virus in 56 patients with haemophilia A 1971-1979.

Stirling, M L; Murray, JM; Mackay, Patricia; Black, S. H.; Peutherer, J F; Ludlam, C. A.

doi:10.1136/jcp.36.5.577

Cited by 24 publications

(9 citation statements)

References 13 publications

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“…This has important implications for donor screening pro grammes which may reduce the number of infected units in plasma pools but not totally eliminate the risk of viral transmission. For example, even highly sensitive screening assays have not prevented hepatitis B virus transmission by factor concentrates [15] and, similarly, donor screening for HIV antibody cannot alone prevent the transmission of HIV because of latent seronegative infection and other factors [16]. Heat treatment reduces the risks of HIV trans mission in concentrate [17,18] and may diminish or remove…”

Section: Anti-b19 Igg Levelmentioning

confidence: 99%

Transmission of Human Parvovirus B19 by Coagulation Factor Concentrates

Williams¹,

Cohen²,

Beddall³

et al. 1990

Vox Sanguinis

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The prevalence of antibody to human parvovirus B19 was determined in 86 children with congenital bleeding disorders. Forty-seven of 53 boys (89%) receiving non-heat-treated factor VIII or prothrombin complex concentrates were anti-B19 IgG positive compared with 38% of their age-matched controls and 48% of children treated with cryoprecipitate. Acute B19 virus infection occurred in 2 boys 3-4 weeks after they had received the same batch of commercial factor VIII concentrate. Of 11 susceptible children who had only received heat-treated National Health Service factor VIII concentrate (8Y), 1 acquired anti-B19 IgG. This suggests that 8Y heat-treated concentrate has a much reduced risk of transmitting B19 virus and, by implication, other less heat-stable viruses such as human immunodeficiency virus.

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Section: Anti-b19 Igg Levelmentioning

confidence: 99%

Transmission of Human Parvovirus B19 by Coagulation Factor Concentrates

Williams¹,

Cohen²,

Beddall³

et al. 1990

Vox Sanguinis

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“…Studies have shown the high incidence of non-A, non-B hepatitis (NANBH) in patients receiving such concentrates for the first time [1,2], and other reports document the transmission of hepatitis B [3] and HIV [4], Heat treatment is an effective means of inactivation of many viruses and can be applied to the lyophilised product. However, experi ence with dry heated factor VIII concentrates suggests that transmission of NANBH is not eliminated by heating for 72 h at 60°C [5] and that, despite the fact that HIV has been shown to be rapidly inactivated at 60 °C in some circum stances [6], patients receiving at least one factor VIII con centrate heated in the lyophilised state for 30 h at 60 °C have seroconverted [7].…”

Section: Introductionmentioning

confidence: 99%

Severely Heated Therapeutic Factor Vili Concentrate of High Specific Activity

Winkelman¹,

Owen²,

Evans³

et al. 1989

Vox Sanguinis

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A new method for the manufacture of a heated factor VIII concentrate of high specific activity (2-6 IU factor VIII:C/mg protein) has been developed. Addition of heparin to cryoprecipitate extract at acid pH precipitated fibrinogen and fibronectin. Factor VIII was then recovered from the supernatant by precipitation with glycine and sodium chloride. After re-solution and desalting on Sephadex G-25, the concentrate was sterile-filtered and lyophilised. The dried product was stable to heating in the final container at 80°C for 72 h. Data from 25 consecutive batches of concentrate prepared from 1,200-1,500 kg plasma pools are presented. The mean final yield of heated product was 190 IU factor VIII:C/kg plasma. The concentrate has been found to be safe and effective in clinical use.

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“…Of these precautions only virus inactivation has clearly reduced the risk of HBV infection in individuals being treated with concentrates made from volunteer plasma. The failure of HBsAg screening to affect the incidence of infection in this group of patients [4] is probably due to the inclusion in plasma pools of small numbers of infectious donations which are HBsAg negative but HBV DNA positive. Nevertheless, our previous studies have shown that the incidence of HBV infection in susceptable individuals receiving screened but nonvirus-inactivated concentrates was only 7% per 6 Blackwell Science Ltd annum, suggesting that very few bottles of concentrate were in fact contaminated with infectious HBV.…”

Section: Discussionmentioning

confidence: 97%

“…Efforts to prevent transmission by screening blood donations for HBsAg successfully decreased the incidence of post-transfusion hepatitis B in recipients of single donor products [3]; however, despite this haemophiliacs remained at risk of infection [4]. Further, certain methods of viral inactivation have failed to prevent transmission of HBV infection [5,6].…”

Section: Hepatitis B Virus (Hbv) Infection Is Recognized As a Common mentioning

confidence: 99%

Hepatitis B serology and DNA detection in multitransfused haemophiliacs and factor VIII and IX concentrates

et al. 1996

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To assess the effect of HIV infection and the introduction of virus-inactivated concentrates, we conducted a retrospective 20-year longitudinal study of hepatitis B virus (HBV) serology and look for HBV DNA in recent serum samples of 63 multiply transfused haemophiliacs. Of 63 haemophiliacs, 51 had evidence of previous HBV infection and 12 vaccinees had anti-HBs only. Of 40 HIV-negative, two had persistent HBsAg but all were HBV DNA negative. All 23 HIV-positive were HBsAg-negative. Loss of anti-HBc(46% vs. 17.5%) and anti-HBs (32% vs. 14%) was more commonly seen in HIV-infected compared with noninfected individuals. One HIV-positive individual had HBV DNA detectable by PCR. Restrospective testing demonstrated that re-emergence was associated with loss of anti-HBs and advanced HIV infection (CD4<50 × 10(6-1) L CDC II), although eight other with CDC IV disease were HBV DNA negative. Forty-three batches of concentrates produced between 1965 and 1992 from both commercial and volunteer donors and subjected to different donor screening and virus inactivation methods were negative for HBV DNA. Some of these may have been infectious for HBV and therefore being negative for HBV may not equate with noninfectivity. We conclude that both HIV-positive and -negative haemophiliacs have lost protective antibodies against HBV since 1984 and that virus replication may re-emerge at least in the HIV-positive group. These observations may have implications for the management of their chronic liver disease and the risk of infection of sexual partners and medical attendants.

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Incidence of infection with hepatitis B virus in 56 patients with haemophilia A 1971-1979.

Cited by 24 publications

References 13 publications

Transmission of Human Parvovirus B19 by Coagulation Factor Concentrates

Transmission of Human Parvovirus B19 by Coagulation Factor Concentrates

Severely Heated Therapeutic Factor Vili Concentrate of High Specific Activity

Hepatitis B serology and DNA detection in multitransfused haemophiliacs and factor VIII and IX concentrates

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