Acquired factor VIII inhibitor in patients with hepatitis C virus infection and the role of interferon-α: A case report

Schreiber, Zwi A.; Bräu, Norbert

doi:10.1002/ajh.20405

Cited by 18 publications

(20 citation statements)

References 14 publications

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“…The development of inhibitors in association with antiviral therapy for chronic hepatitis C is poorly understood. Schreiber and Bräu proposed that the presence of anti‐FVIII autoantibodies in hepatitis C infection was, in some cases, extrahepatic autoimmune manifestations similar to cryoglobulinemia and hepatitis‐induced thrombocytopenia . Otherwise, a large retrospective study that analysed surveillance data collected on 7386 American males with severe haemophilia A over a 13‐year period did not found association between inhibitor development and HCV infection .…”

Section: Discussionmentioning

confidence: 78%

Prevalence and risk factors associated with hepatitis C among Brazilian male patients with haemophilia: A long‐term follow‐up

et al. 2019

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People with haemophilia represent a population with a high prevalence of HCV infection due to the use of blood components and plasma‐derived clotting factor concentrates before the introduction of viral‐inactivating procedures (in the 1980s) and screening for HCV (in the 1990s). About 80% of HCV‐infected patients have chronic HCV infection, and at least 20% develop end‐stage liver disease. The aim of the study was to assess current anti‐HCV positivity in a large cohort of Brazilian haemophilia patients and to determine associated factors with HCV exposure. The study retrospectively analysed medical records of all male haemophilia patients attended the main public referral blood centre in Belo Horizonte, Brazil, from January 1985 to January 2015. Sociodemographic, epidemiological and serological characteristics were collected of all participants tested for anti‐HCV. Among 724 patients enrolled in the study, anti‐HCV was positive in 259 resulting in a seroprevalence of 35.8% (95% CI: 32.3%‐39.3%). Factors independently associated with previous exposure to HCV were as follows: age older than 30 years, moderate to severe haemophilia, detection of inhibitor at least once in lifetime and previous exposure to hepatitis B virus (HBV) infection or HIV infection. Otherwise, exclusive previous use of inactivated clotting factors resulted in a significant decrease in the chance of positivity for anti‐HCV. At the end of cohort period, patients with positive anti‐HCV had a 3‐fold higher risk of death. This study showed that hepatitis C infection remains a critical problem for Brazilian haemophilia patients and reinforced the need to unify efforts to eradicate it.

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Section: Discussionmentioning

confidence: 78%

Prevalence and risk factors associated with hepatitis C among Brazilian male patients with haemophilia: A long‐term follow‐up

et al. 2019

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“…Several reviews have shown that both solid tumors and hematologic malignancies can cause this phenomenon, with lung and prostate adenocarcinoma and low grade lymphoproliferative diseases being the most common culprits [17–22]. Although there have been several case reports describing patients with HCV who developed acquired FVIII inhibitors, most of these patients were undergoing treatment with interferon, a known immunomodulatory agent [24–28]. Schreiber and Bräu proposed that the presence of autoantibodies to FVIII in HCV was in fact extrahepatic autoimmune manifestations similar to cryoglobulinemia and hepatitis-induced thrombocytopenia [24].…”

Section: Discussionmentioning

confidence: 99%

“…Although there have been several case reports describing patients with HCV who developed acquired FVIII inhibitors, most of these patients were undergoing treatment with interferon, a known immunomodulatory agent [24–28]. Schreiber and Bräu proposed that the presence of autoantibodies to FVIII in HCV was in fact extrahepatic autoimmune manifestations similar to cryoglobulinemia and hepatitis-induced thrombocytopenia [24]. There have been several case reports associating inhibitors with HIV, but these were all seen in patients receiving HAART and were attributed to IRIS [28–32].…”

Section: Discussionmentioning

confidence: 99%

An Acquired Factor VIII Inhibitor in a Patient with HIV and HCV: A Case Presentation and Literature Review

Zeichner

Harris

Turner

et al. 2013

Case Reports in Hematology

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Introduction. Despite its low incidence, acquired factor VIII inhibitor is the most common autoantibody affecting the clotting cascade. The exact mechanism of acquisition remains unclear, but postpartum patients, those with autoimmune conditions or malignancies, and those with exposure to particular drugs appear most susceptible. There have been several case reports describing acquired FVIII inhibitors in patients receiving interferon alpha for HCV treatment and in patients being treated for HIV. To our knowledge, this is the first case of a patient with HCV and HIV who was not actively receiving treatment for either condition. Case Presentation. A 57-year-old Caucasian male with a history of HIV and HCV was admitted to our hospital for a several day history of progressively worsening right thigh bruising and generalized weakness. CTA of the abdominal arteries revealed large bilateral retroperitoneal hematomas. Laboratory studies revealed the presence of a high titer FVIII inhibitor. Conclusion. Our case of a very rare condition highlights the importance of recognizing and understanding the diagnosis of acquired FVIII inhibitor. Laboratory research and clinical data on the role of newer agents are needed in order to better characterize disease pathogenesis, disease associations, genetic markers, and optimal disease management.

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“…Certain medications such as penicillins, sulfa drugs and phenytoin have been reported as causes of acquired haemophilia [3]. Interferon‐α use in a non‐haemophilic patient with chronic hepatitis C infection has been reported to be an extremely rare cause of this presentation [2,4]. HCV could itself be associated with autoimmune manifestations including haematological side effects like mixed cryoglobulinemia, thrombocytopenia and generation of autoantibodies like antinuclear antibody, rheumatoid factor, antismooth muscle cell, anticardiolipin and antithyroglobulin antibodies [5].…”

Section: Discussionmentioning

confidence: 99%

Acquired haemophilia in a patient treated with interferon‐α for hepatitis C infection

Goyal¹,

Tyagi²,

Kumar³

2012

Haemophilia

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Acquired factor VIII inhibitor in patients with hepatitis C virus infection and the role of interferon-α: A case report

Cited by 18 publications

References 14 publications

Prevalence and risk factors associated with hepatitis C among Brazilian male patients with haemophilia: A long‐term follow‐up

Prevalence and risk factors associated with hepatitis C among Brazilian male patients with haemophilia: A long‐term follow‐up

An Acquired Factor VIII Inhibitor in a Patient with HIV and HCV: A Case Presentation and Literature Review

Acquired haemophilia in a patient treated with interferon‐α for hepatitis C infection

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