Risk factors for infection with HBV and HCV in a largecohort of hemophiliac males

Abstract

PWHs who received clotting factor concentrates before 1990 may be at risk for infection with hepatitis B or hepatitis C and should be tested.

Effects of HIV infection on age and cause of death for persons with hemophilia A in the United States

“…For practical purposes in the United States, HIV infection among hemophilia patients born after 1985 is non-existent [40]; above age 15, HIV seroprevalence increases by age cohort [41,42]. With increasing age at seroconversion, the incidence of AIDS-defining illnesses increases [43][44][45] and survival decreases [46,47], indicating a negative effect of age on tolerance to HIV infection.…”

“…Most recipients of non-heat-treated plasma-derived factor concentrates have been infected with HBV [50] and HCV [40,51]. At least 50% of those infected with HCV get chronic hepatitis, and many eventually get cirrhosis [52].…”

Correlates of spontaneous clearance of hepatitis C virus among people with hemophilia

“…10,12 People with hemophilia receiving clotting factor replacement therapy were at very high risk of infection with HCV before the introduction of donor screening and virus inactivation in the mid-1980s. [13][14][15] Of HCV antibody-positive patients with hemophilia, spontaneous clearance of HCV RNA has been reported in about 25% of those without HIV-1 coinfection compared with 10% or less of those with HIV-1 coinfection. 6,[16][17] The clinical and epidemiologic determinants of HCV clearance in hemophilic patients are not well defined, although clearance may be more frequent among those infected at a younger age.…”

The Aging Patient with Hemophilia: Complications, Comorbidities, and Management Issues

“…Between 85% and 93% of US males with hemophilia born before 1975 have been found to be positive for HCV infection, and 27% to 51% of similar birth cohorts have been found to be positive for hepatitis B infection. 10 A significant difference between HCV-infected hemophilia patients and nonhemophilia patients is the duration of their infection. Hemophilia patients usually acquired their HCV infection in the first year of life with their first factor infusion, and pre-liver transplant survival in hemophilia patients has been reported to be much shorter than in non-hemophilia patients.…”

“…7 Clotting factor concentrates virally safe from HIV have been available since 1985, and hepatitis B and C virally safe concentrates have been available since 1992. 10 Viral safety was achieved initially using viral-inactivation methods for plasmaderived factor concentrates before recombinant factor products were developed. By 2001, hemophilic (all severities combined) life expectancy in The Netherlands had increased to 67 years (74 years excluding virally infected hemophiliacs), and by 2007, the overall hemophilic life expectancy was reported to be 71 years in Italy.…”