Hemophilia in Jordan: study of inhibitors and viral status

ABSTRACT

This work aims at studying inhibitors to factor VIIIC, factor IX C in Jordanian patients with Hemophilia A and B and the prevalence of hepatitis B, C, HIV viruses in these patients. A total of99 male patients were included in the study. Of these, 83 [83.8%] are hemophilia A and 16 [16.2%] are hemophilia B. All were investigated for inhibitor development by Bethesda assay. Inhibitors for factor VIIIC were additionally test by an ELISA technique. Each Patient's serum was tested by ELISA for the presence of antibodies against hepatitis A, B, and C viruses as well as against HIV I and II. Those found positive for hepatitis C antibodies were tested by PCR for hepatitis C viral RNA. None of the hemophilia B patients were found to have inhibitors. Eight patients [9.6%] of hemophilia A were found to have inhibitors. The prevalence of antibodies for hepatitis C was 25.25%, for hepatitis B 0% and for HIV 1%. Of those who were HCV antibody positive, 13 [52%] were positive for HCV-RNA by PCR. It is concluded that inhibitor development in Jordanian hemophilia A patients is similar to that described in western countries. Regular monitoring of these inhibitors should be an essential part of the routine care and follow-up of hemophilia A patients. The high prevalence of HCV indicates the need for more rigorous hepatitis C screening in local blood to render it safer than it is