The development of antiphospholipid antibodies in haemophilia is linked to infection with hepatitis C

Abstract

In haemophilia the presence of antibodies to antiphospholipid has been linked with HIV infection, but other possibilities have not been fully explored and the specificity for various phospholipids not established. In order to investigate further the pathogenesis and clinical significance of these antibodies, we have determined IgG and IgM antibodies to a variety of phospholipids, including cardiolipin, in the serum of 52 haemophiliacs, and related our findings to the presence of antibodies to HIV and hepatitis C virus (HCV), as well as to clotting factor concentrate usage and blood markers of liver biochemistry. Our results demonstrate that the presence of infection with hepatitis C virus is strongly associated with raised serum levels of antiphospholipid antibody even in the absence of HIV infection. They suggest that earlier conclusions on the relationships of antiphospholipid to HIV infection in haemophilia should be revised and that chronic infection with the hepatitis C virus should be added to the list of infective causes for the development of antiphospholipid antibody.

Lupus Anticoagulants and Their Relationship with the Inhibitors against Coagulation Factor VIII: Considerations on the Differentiation between the 2 Circulating Anticoagulants

“…These conclusions are further supported by the findings of a very low prevalence of patients who tested positive in 3 tests for aPL antibodies. The latter finding contrasts with other reports in which the prevalence of positive anti-cardiolipin in hemophiliacs was high and associated with the occurrence of such markers of infections as HIV (4 ), HCV (20 ), or both (20 ). The low prevalence of HIV (8 of 49 patients) in our cohort may in part explain the contrasting findings.…”

The antiphospholipid syndrome and infection

“…The non-organ-specific antibodies include the antinuclear, smooth muscle, antineutrophil, and liverkidney microsomal antibodies [11,12,20••,26]. aCL antibodies have also been reported in patients with HCV [11,13•,20••,27-29,30•,,3132•, [33][34][35][36][37][38][39].…”

High prevalence of anticardiolipin antibodies in hepatitis C virus infection: lack of effects on thrombocytopenia and thrombotic complications

“…6,7 It has been suggested that chronic infection with HCV induces autoimmune reactions to platelets, leading to thrombocytopenia. 8,9 Recently, an association between HCV infection and anticardiolipin antibodies was suggested, 10 and anticardiolipin antibodies have been implicated in HCV-associated thrombocytopenia. 11 Antiphospholipid antibodies, which include anticardiolipin antibodies, are a family of autoantibodies against negatively charged phospholipids that are complexed with phospholipid-binding proteins.…”