Lack of Knowledge About Hepatitis C Infection Rates Among Patients With Inherited Coagulation Disorders in Countries Under the Eastern Mediterranean Region Office of WHO (EMRO): A Meta-Analysis

Abstract

Context: Hepatitis C virus (HCV) infection is a public health problem. HCV alone is responsible for 90% cases of acute hepatitis among multiply transfused patients who are at risk of cirrhosis and hepatocellular carcinoma (HCC). Objectives: To provide a clear picture of available data, we performed a systematic review of the epidemiological characteristics of HCV infection among patients with inherited coagulation disorders in the countries under the Eastern Mediterranean Region Office (EMRO). Evidence Acquisition: Meta-analysis was carried out on the basis of results of electronic and manual search. This analysis included studies in English, French, and Persian that met with the following criteria: (1) appropriate study design: cross-sectional, case-control, and cohort; (2) studies reporting HCV prevalence according to enzyme immune assay; (3) studies in which the sample population was enrolled from EMRO countries. According to the results of the heterogeneity tests, we used fixed-effect/random-effect model for our meta-analysis, with the "Metan" command. Results:We included 30 studies, most of which were from Iran. The mean age of the subjects ranged from 13 to 27.1 years. The majority of the patients were male (range, 81% to 100%). The pooled estimate of HCV infection among patients with inherited coagulation disorders was 48.07% (95% confidence interval [CI], range: 27.39-55.68) in Iran, 36.03% (95% CI, range: 4.466-67.598) in Pakistan, and 48.27% (95% CI,) in all the EMRO countries taken together. Conclusions: In Iran and other EMRO countries, the HCV infection rate among patients with inherited coagulation disorders is high. Our study shows that there is a lack of knowledge about infections in such patients in most of the EMRO countries. It is the responsibility of health-policy makers to address this knowledge gap and provide safe and adequate treatment for patients in high-risk groups.

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

“…Hepatitis C antibody positivity, in this Brazilian cohort of patients with haemophilia, was significantly higher than that estimated by the World Health Organization for the general population in Latin America (35.8% vs 0.7%, respectively) . However, this result is slightly lower than that found in other populations with haemophilia worldwide, as recently described in the United States (32.6%‐92.3%), Western and Central Europe (55.8%), Taiwan (54.3%), Middle West countries (48.3%) and Australia (52.0%) …”

“…Nevertheless, the high HCV prevalence among patients with haemophilia around the world persists until now . A Brazilian national report supported by data collected from 2005 to 2007 showed that 34.9% and 29.7% of Brazilian patients with haemophilia A and B, respectively, were hepatitis C antibody (anti‐HCV)‐positive .…”

Treatment of hepatitis C virus infection with direct-acting antiviral agent-based regimens in Iranian patients with hereditary bleeding disorders

“…Due to the lack of effective blood and blood product screening before 1990, many patients with HBD were infected with the hepatitis C virus (HCV) [1]. A metaanalysis showed that 48% of Iranian hemophilic patients were infected with HCV that also varies 24-89% in different countries of the world [1,2]. About 75-85% of patients who contracted HCV will develop chronic hepatitis C (CHC), which is associated with the increased risk of cirrhosis, end-stage liver diseases, and hepatocellular carcinoma [3].…”

Impact ofIFNL4rs12979860 and rs8099917 polymorphisms on response to Peg-Interferon-α and Ribavirin in patients with congenital bleeding disorder and chronic hepatitis C

“…Treated or recombinant clotting factors are now utilized routinely, and new cases of HCV infection in patients with congenital bleeding disorders are uncommon . The prevalence of hepatitis C among hemophilic patients varies from 24% to 95% throughout the world . Prior to the introduction of efficacious HCV direct‐acting antiviral agents (DAAs) in 2011, A 24‐48 week course of Pegylated‐Interferon‐α‐2a (PegIFN‐α‐2a) or PegIFN‐α‐2b combined with Ribavirin (RBV; PegIFN/RBV) was the recommended treatment for CHC .…”