Résumé
The risk of blood-borne infections, especially hepatitis C virus [HCV] and human immunodeficiency virus [HIV] infection still remains in developing countries among children receiving blood products as hemophiliacs, but the risk is not known in Egypt. The objective of this study was to detect the prevalence of HCV and HIV infection among hemophiliac children to know the magnitude of the problem and determine potential risk factors. This was a cross-sectional study conducted on 100 hemophiliac children that assessed the liver clinically and by laboratory tests. All children were screened for HCV and HIV antibodies by enzyme-linked immunosorbent assay. Those with positive HCV antibody titre were tested by polymerase chain reaction [HCV-PCR]. Forty were positive for HCV antibodies with 19 children [47.5%] HCV-PCR positive as well. The mean age, average frequency of bleeds/year, dose of replacement therapy/year and alanine aminotransferase [ALT] levels were significantly high in HCV-antibody and PCR positive patients as compared to HCV antibody and PCR negative ones. None of our patients had clinical evidence of hepatic involvement or was co-infected with HIV HIV infection does not appear to be a current health problem in Egyptian hemophiliac children though the prevalence of HCV infection is still high
Sujets)
Humains , Enfant d'âge préscolaire , Enfant , Adolescent , Infections à VIH/épidémiologie , Hémophilie A/complications , Hémophilie A/virologie , Prévalence , Hémophilie B/complications , Hémophilie B/virologie , Test ELISA , Études transversalesRésumé
O objetivo deste estudo foi analisar parâmetros sorológicos e virológicos em hemofílicos no Estado da Bahia. O anti-VHC foi investigado por ELISA em uma coorte de 268 hemofílicos A/B sob acompanhamento em uma unidade de referência do Estado da Bahia. A viremia do VHC e genótipos foram determinados em um subgrupo de 66 hemofílicos soropositivos para o anti-VHC. A soroprevalência do anti-VHC entre os hemofílicos foi de 42,2% (IC 95% 36,5-48,1) e foi associada significativamente (p<0,05) a idade >10 anos, presenca de anticorpos antifator VIII/IX e outros marcadores sorológicos de infeccão. Nenhum dos hemofílicos com idade inferior a 5 anos foram anti-VHC positivos. A viremia foi detectada em 77,3% (51/66), sendo o genótipo 1 do VHC (74%) o mais prevalente, seguido pelos genótipos 3 (22%) e 2 (4%). Nossos resultados indicam que a prevalência do VHC é ainda alta entre os hemofílicos, muito embora a transmissão não tenha sido observada entre os menores de 5 anos.
Sujets)
Nourrisson , Enfant d'âge préscolaire , Enfant , Adolescent , Adulte , Adulte d'âge moyen , Humains , Mâle , Hémophilie A/virologie , Hémophilie B/virologie , Hepacivirus/immunologie , Anticorps de l'hépatite C/sang , Hépatite C/épidémiologie , Marqueurs biologiques/sang , Facteurs de la coagulation sanguine/immunologie , Brésil/épidémiologie , Études de cohortes , Test ELISA , Génotype , Hémophilie A/sang , Hémophilie B/sang , Hepacivirus/génétique , Hépatite C/diagnostic , Hépatite C/virologie , Prévalence , Facteurs de risque , ARN viral/sang , Études séroépidémiologiques , Indice de gravité de la maladie , VirémieRésumé
Viral contamination with blood products is a major problem in patients with hemophilia. The aim of this study is to look for viral infection ie hepatitis and immunodeficiency syndrome virus in patients with hemophilia in our institution. Hence, 40 patients have been studied. Viral hepatitis is found in 43% of cases, witch is in accordance with the results found by the majority of authors. On the other hand, since our patients have seldom been treated with factor VIII concentrate, no impaired immunodeficiency syndrome have been found