Hepatitis C virus (HCV) in children and adolescent hemophiliacs

Abstract

IntroduçãoO efeito indesejável mais notório das transfusões sangüíneas é a aquisição de hepatites virais. As múltiplas exposições dos hemofílicos ao uso de derivados do sangue colocam este grupo em extremo risco na aquisição destas hepatites. Comprovadamente implicados nas hepatites pós-transfusionais, desenvolvidas pelos hemofílicos, ResumoObjetivo: Avaliar a soroprevalência de infecção pelo HCV entre hemofílicos no Estado do Pará e a possível relação com nível sérico de enzimas hepáticas, tipo de hemofilia, idade, gravidade, combinação e tipo de tratamento e data de início de tratamento com hemoderivados.Métodos: Estudo epidemiológico com corte transversal, analisando 62 pacientes hemofílicos do Centro de Hemoterapia do Pará (HEMOPA), nascidos a partir de 01/01/80, através de revisão de prontuário, exame físico e exames laboratoriais: Anti-HCV (ELISA 3ª geração), Reação de cadeia de polimerase -PCR -(HCV-RNA )e dosagem de níveis séricos de transaminases (ALT e AST) . A análise estatística dos dados foi feita aplicando os testes do qui-quadrado e o teste exato de Fisher, considerando-se significantes os resultados de p< 0,05.Resultados: Dos 62 pacientes analisados, 48,4% (n=30) eram soropositivos para o HCV. Dentre estes pacientes, 43,3% (n=13) apresentavam viremia com detecção de RNA viral pela técnica de PCR. A infecção pelo HCV se relacionou com data de início de tratamento anterior a 1993(p= 0,0005); com o tipo de hemofilia, sendo o tipo A mais freqüente (p=0,028); com gravidade, sendo mais freqüente na forma moderada (p=0,026); e com faixa etária, sendo mais freqüente acima dos 5 anos de idade (p=0,025).Conclusões: A infecção pelo HCV entre hemofílicos no Estado do Pará é elevada (48,4%) e se relacionou com início de tratamento anterior a 1993, quando se iniciou a triagem sorológica obrigatória para HCV nos bancos de sangue no Brasil. É também significantemente mais freqüente entre crianças com idade superior a 5 anos, com hemofilia do tipo A e com hemofilia de gravidade moderada. J. pediatr. (Rio J.). 1998; 74(4): 325-332:hepatite, hemofilia, doença de Christmas. AbstractObjective: To evaluate the prevalence of infection by HCV among hemophiliacs in the State of Pará (Brazil), and its possible relation to hepatic enzymes serum level, type of hemophilia involved, age, level of severity, kinds and combinations of treatment, as well as date in which treatment with hemoderivates was started.Methods: Cross-sectional epidemiological investigation, analyzing 62 hemophilic patients of the Centro de Hemoterapia do Pará (HEMOPA), all born after 01/01/80, by means of the review of the medical records, physical examination and laboratory tests: Anti-HCV (ELISA 3.0), polymerase chain reaction -PCR -(HCV-RNA), and dosage of transaminases serum levels. Statistical analysis was carried out using Chi-square and Fisher's Exact Test, the results being considered significant if p<0.05.Results: Out of the 62 patients analyzed, 48.4% (n=30) were HCV positive. Among these patients, 43.3% (n=13) presented viraemia with detectio...

Inherited coagulation disorders in the northwestern region of Iran

“…Despite of inability to determine the infectious status of many cases of haemophilia A and B through their recording profiles, we could estimate that our HCV positive cases were fewer than those reported from the Gilan. Our data are similar to [8] and Turkey (Kocabas et al) [9]. This study showed lower occurrence of HBs-Ag positive cases compared with the similar reports from neighbouring countries.…”

Hepatitis C Virus among Female Sex Workers: A Cross-Sectional Study Conducted along Rivers and Highways in the Amazon Region

“…In the Amazon region, the estimated prevalence of HCV infection ranges from 1% to 3%, with higher rates being recorded in vulnerable groups, such as PWUDs (23.1%), patients undergoing hemodialysis (8.4%), and patients with hemophilia (48.4%) [5,[20][21][22][23][24]29,36,46]. The prevalence of HCV infection detected in this study was 10.7%, and most of these infections were classified as active (7.8%).…”

“…Furthermore, resistance-associated substitutions (RASs) located in NS3, such as V36L, V55A, Q80L, and R155K for subtype 1a, and T54S, V55A, R117H, and D168G for subtype 1b, have already been identified in HCV-infected Brazilians [19]. In the Amazon region (northern Brazil), several epidemiological studies indicate a high prevalence of HCV infections and the predominance of genotype 1 in different population groups, such as indigenous people, people living in riverside communities, blood donors, patients undergoing hemodialysis, patients with multiple blood transfusions, and PWUDs [5,18,[20][21][22][23][24][25]. Factors associated with parenteral and sexual exposure to HCV have been detected, including: Shared use of manicure and pedicure instruments, use of home-sterilized needles and syringes, unprotected sexual intercourse, more than 12 sexual partners, daily drug use, drug use for more than three years, and shared use of drug paraphernalia [5,[26][27][28][29].…”

Serological markers of hepatitis A, B and C viruses in rural communities of the semiarid Brazilian Northeast

“…In contrast, there is a high prevalence of hepatotrophic viruses in the Amazon region with virological peculiarities, such as genotype F of HBV [8,9] and hepatitis D virus [10]. Many Brazilian studies, as well as international studies, describe the prevalence of hepatotrophic viruses among specific groups, such as blood donors [11], patients in hemodialysis programs [12][13][14], hemophiliacs [15], afro-descendants [16], mental disease patients [17] and hepatitis patients [18,19]. Due to a lack of studies conducted on the Brazilian northeastern semiarid region, we examined the distribution of hepatitis A (HAV), B (HBV) and C (HCV) serological markers in this population.…”