An Outbreak of Hepatitis A among Irish Haemophiliacs

Johnson, Z.; Thornton, Lelia; Tobin, Anne; Lawlor, Emer; Power, Joan; Hillary, Irene B.; Temperley, I. J.

doi:10.1093/ije/24.4.821

Cited by 31 publications

(22 citation statements)

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“…Although a rare occurrence, transmission through the parenteral route is possible, with cases reported after blood transfusions in neonates and adults [3][4][5]. Recently, cases of hepatitis A have been linked to receipt of factor VIII concentrates in Europe [6][7][8][9] and South Africa [10] and to receipt of factor VIII and IX concentrates in the United States [11].…”

Section: The Duration Of Viremia and Time Course For Development Of Imentioning

confidence: 99%

Duration of Viremia in Hepatitis A Virus Infection

et al. 2000

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The duration of viremia and time course for development of IgM antibodies were determined prospectively in natural and experimental hepatitis A virus (HAV) infection. Serial serum samples from HAV-infected men (n=13) and experimentally infected chimpanzees (n=5) were examined by nested reverse-transcriptase polymerase chain reaction analysis to detect HAV RNA and by ELISA to detect IgM antibodies to HAV. Among infected humans, HAV RNA was detected an average of 17 days before the alanine aminotransferase peak, and viremia persisted for an average of 79 days after the liver enzyme peak. The average duration of viremia was 95 days (range, 36-391 days). Results were similar in chimpanzees. In addition, HAV RNA was detected in serum of humans and chimpanzees several days before IgM antibodies to HAV were detected. These results indicate that adults with HAV infection are viremic for as long as 30 days before the onset of symptoms and that the duration of viremia may be longer than previously described.

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Section: The Duration Of Viremia and Time Course For Development Of Imentioning

confidence: 99%

Duration of Viremia in Hepatitis A Virus Infection

et al. 2000

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“…In Ireland, the HAV infection cluster was confined to the haemophilia A patients treated with sol vent-detergent-treated factor VIII produced by Octapharma (Vienna) [3], These findings indicate that factor IX concentrates can transmit HAV This is supported by a recent report [16] of a case of HAV transmission by solvent-detergent-treated fac tor IX concentrate, full details of which are not yet available. It is possible that previous clusters of HAV infection associ ated with such blood products may not have been noticed due to the widespread belief that factor concentrates did not transmit HAV infection.…”

Section: Resultsmentioning

confidence: 87%

“…A limited retrospective review of the infectivity of this batch has been undertaken from data obtained in 1991-1992 during investigation of the hepatitis A cluster in the hae mophilia A cases [3]. This showed that of the 21 patients who either definitely (n = 8) or probably (n = 13) received batch 90742 all were anti-HAV IgG positive in 1991-1992.…”

Section: Manufacture Of Factor IX Concentratementioning

confidence: 99%

“…This absence of transmission was believed to be due to the rarity of HAV viraemia in the blood donor pop ulation, the high levels of anti-HAV antibodies in the pooled plasma destined for fractionation and the presence of anti-HAV antibodies in intermediate-purity factor VIII concen trates which would neutralise any virus present. However, clusters of HAV infection were reported in Italy, Germany, Ireland, Belgium and South Africa between 1989-1994 in haemophilia A patients treated with solvent-detergenttreated factor VIII concentrates [2][3][4][5][6], which contained lit tle or no immunoglobulin [7].…”

Section: Introductionmentioning

confidence: 99%

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Hepatitis A Transmission by Factor IX Concentrates

Lawlor¹,

Graham²,

Davidson³

et al. 1996

Vox Sanguinis

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Factor IX concentrates unlike factor VIII concentrates have not to date been associated with the transmission of hepatitis A virus (HAV). A retrospective study by reverse transcriptase polymerase chain reaction on a batch of factor IX concentrate used to treat two haemophilia B patients who developed jaundice and IgM anti-H AV antibodies within 50 days of factor IX administration in 1985 revealed the presence of HAV RNA. These findings indicate that factor IX concentrates can transmit HAV and that appropriate viral inactivation steps to inactivate nonenveloped viruses as well as enveloped viruses are necessary to ensure the safety of factor IX concentrates.

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“…The patients receiving clotting factor concentrate, particularly products inactivated by solvent-detergent which was ineffective against nonlipid enveloped viruses such as HAV (25)(26)(27)(28)(29)(30). In developed countries, hepatitis A vaccine is recommended for HAV seronegative people with clotting disorders, and those with CLD (31,32).…”

Section: Discussionmentioning

confidence: 99%

The Seroprevalence of Entrically Transmitted Viral Hepatitis in HCV Infected Thalassemia and Hemophilia Patients in Iran

Elizee

Alavian

Miri

et al. 2013

Jundishapur J Microbiol

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Background: Hepatitis A and E virus (HAV and HEV) infections are acute and self-limited diseases that usually spread through oral-fecal route. Also, blood transfusion as a possible route of entrically transmitted hepatitis has been suggested. Hemophilia and thalassemia patients are highly at risk of transfusion-transmissible viruses (HBV, HCV, and HIV). Any superimposed infection with other viral hepatitis (in particular hepatitis A) cause active liver failure in hemophilia and thalassemia patients. Objectives: The aim of this study is to consider seroprevalence of anti HAV and HEV antibodies (Ab) in thalassemia and hemophilia patients with chronic hepatitis C in Iran. Patients and Methods:In a cross-sectional study and under general census sampling, sera of 219 thalassemia and hemophilia patients infected with HCV were examined in Tehran Hepatitis Center (THC) between 2009 and 2010. Enzyme-linked immunisorbentassey (ELISA) was done to observe anti HAV and HEV IgG Ab. Patients were chosen from all provinces of Iran. Results: Anti-HAV IgG antibodies were observed more frequently in thalassemia patients (60/64; 93.8%) than in hemophilia patients (104/155; 67.1%, P < 0.001). The seroprevalence of both antibodies increased with age. Among thalassemia patients, there was no significant association between HAV seropositivity and other variables, but in hemophilia group, seropositive patients were significantly older than seronegative group (P < 0.05). Totally, anti HEV Ab (1/64; 1.6% thalassemia and 5/155; 3.2% hemophilia) was seropositive in six patients. There was no significant association between HEV infection and other variables in thalassemia patients, however, in hemophilia patients, HEV positive ones were significantly older than HEV negative group (P=0.01). Conclusions: Vaccination of non-immune individuals against HAV infection in high risk groups especially hemophilia and thalassemia patients is recommended. Results did not show any differences about seroprevalence of HEV among Iranian general population.

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An Outbreak of Hepatitis A among Irish Haemophiliacs

Abstract: Although person-to-person transmission is likely to have caused a few of the cases, the results of our investigation suggest that the major contributing factor was exposure to certain batches of SD-treated factor VIII.

Cited by 31 publications

References 0 publications

Duration of Viremia in Hepatitis A Virus Infection

Duration of Viremia in Hepatitis A Virus Infection

Hepatitis A Transmission by Factor IX Concentrates

The Seroprevalence of Entrically Transmitted Viral Hepatitis in HCV Infected Thalassemia and Hemophilia Patients in Iran

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