Prevalence of transfusion transmitted infections in children with inherited coagulation disorders

Urmila K. V., Sarin S. M., Mohammed M. T. P.


Background: Factor replacement and blood product transfusion are the main stay of treatment of inherited coagulation disorders. Even though interventions with these products have led to the decrease in morbidity and mortality of these patients, repeated use of these products especially before 1980s where the viral inactivation of factors and blood bank screening methods were not stringent, have led to the occurrence of transfusion transmitted diseases in haemophiliacs especially hepatitis C infection.

Methods: 50 children including adolescents under the age of 18 years with inherited coagulation disorders were screened for hepatitis B and C infection during 2 medical camps conducted at an interval of 6 months, blood samples and medical information were collected prospectively during these periods. The blood samples were tested for surrogate marker for hepatitis B and anti HCV using enzyme immunoassay.

Results: All the children screened were negative for hepatitis B and C markers.

Conclusions: The incidence of post transfusion hepatitis has dramatically decreased following stringent blood donor screening methods as well as availability of purified and recombinant factors. The current risk of transfusion transmitted infections in these patients are very low almost comparable with general population.


Disorders, Hepatitis B, Hepatitis C, Inherited

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Mannucci PM, Duga S, Peyvandi F. Recessively inherited coagulation disorders. Blood. 2004;104(5):1243-52.

Fernandes H, D’souza PF, D’souza PM. Prevalence of transfusion transmitted infections in voluntary and replacement donors. Indian J Hematol Blood Transfus. 2010;26(3):89-91.

Franchini M, Mannucci P. Past, present and future of hemophilia: a narrative review. Orphanet J Rare Dis. 2012;7(1):24.

Amitrano L, Guardascione MA, Brancaccio V, Balzano A. Coagulation disorders in liver disease. Semin Liver Dis. 2002;22:83-96.

Unim B, Veneziano MA, Boccia A, Ricciardi W, La Torre G. Haemophilia A: Pharmacoeconomic Review of Prophylaxis Treatment versus On-Demand. Sci World J. 2015;2015:1-9.

Oldenburg J. Optimal treatment strategies for hemophilia: achievements and limitations of current prophylactic regimens. Blood. 2015;125(13):2038-44.

Tetali S, Choudhury PL. Occupational exposure to sharps and splash: risk among health care providers in three tertiary care hospitals in South India. Indian J Occupa Environ Med. 2006;10(1):35.

Brower C. National Hemophilia Foundation. Hepatitis and Hemophilia. 2012. Available at

Rizza CR. Inhibitors of fibrinolysis in the treatment of haemophilia. J Clin Pathol Suppl (R Coll Pathol). 1980;14:50.

Slaymaker IM, Gao L, Zetsche B, Scott DA, Yan WX, Zhang F. Rationally engineered Cas9 nucleases with improved specificity. Science. 2016;351(6268):84-8.

Zhang M. Correlates of spontaneous clearance of hepatitis C virus among people with hemophilia. Blood. 2005;107(3):892-7.

Choudhury N, Ramesh V, Saraswat S, Naik S. Effectiveness of mandatory screening tests in Indian blood donors. Indian J Med Res. 1995;64:541-4.

Kalantari H, Rad N. Efficacy of interferon alpha-2b with or without ribavirin in thalassemia major patients with chronichepatitis C virus infection: a randomized, double blind, controlled, parallel group trial. J Res Med Sci. 2010;15(6):310-6

Carmo RA, Oliveira GC, Guimarães MDC, Oliveira MS, Lima AA, Buzek SC, et al. Hepatitis C virus infection among Brazilian hemophiliacs: a virological, clinical and epidemiological study. Braz J Med Biol Res. 2002;35(5):589-98.

Makris M, Preston FE, Rosendaal FR, Underwood JCE, Rice KM, Triger DR. The natural history of chronic hepatitis C in haemophiliacs. Br J Haematol. 1996;94(4):746-52.

Martin C, Nielsen SU, Ibrahim S, Bassendine MF, Toms GL. Binding of Liver Derived, Low Density Hepatitis C Virus to Human Hepatoma Cells. J Med Virol. 2008;80(5):816-23.

Ghosh K, Joshi SH, Shetty S, Pawar A. Transfusion transmitted diseases in haemophilics from western India. Indian J Med Res. 2000;112:61.

Nebbia G, Moroni GA, Simoni L, Belli M, Carnelli V. Hepatitis B virus infection in multitransfused haemophiliacs. Arch Dis Child. 1986;61(6):580-4.

Ikeda K, Saitoh S, Arase Y, Chayama K, Suzuki Y, Kobayashi M, et al. Effect of interferon therapy on hepatocellular carcinogenesis in patients with chronic hepatitis type C: A long-term observation study of 1,643 patients using statistical bias correction with proportional hazard analysis. Hepatol. 1999;29(4):1124-30.

Khodabandehloo M, Roshani D. Prevalence and trend of Hepatitis C infection among blood donors in Iran: a systematic review and meta-analysis. Res Med Sci. 2013;18(8):674-82.

WHO. Global burden of disease (GBD) for hepatitis C. J Clin Pharmacol. 2004;44:20-9.

Sommese L, Sabia C, Paolillo R, Parente D, Capuano M, Iannone C, et al. Screening tests for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus in blood donors: evaluation of two chemiluminescent immunoassay systems. Scand J Infect Dis. 2014;46(9):660-4.

Donahue JG, Muñoz A, Ness PM, Brown Jr DE, Yawn DH, McAllister Jr HA, et al. The declining risk of post-transfusion hepatitis C virus infection. New Eng J Med. 1992;327(6):369-73.

Karimi M, Yarmohammadi H. Inherited coagulation disorders in Southern Iran. Haemophilia 2002;8(6):740-4.

Samimi-Rad K, Rahimnia R, Sadeghi M, Malekpour SA, Marzban M, Keshvari M, et al. Epidemic history of Hepatitis C virus among patients with inherited bleeding disorders in Iran. PloS One. 2016;11(9):e0162492.

Ruzzenenti MR, De Luigi MC, Bruni R, Giannini G, Bo A, Valbonesi M, Barresi R. PCR testing for HCV in anti-HCV negative blood donors involved in the so-called HCV+ ve post-transfusion hepatitis. Transfusion Sci. 2000;22(3):161-4.

Junaid M, Siddique AN, Khan MT. Detection and prevalence of hepatitis B, C and HIV viral infections among hemophilia patients in Peshawar, Pakistan. JEZS. 2017;5(2):180-4.

Jongerius JM, Wester M, Cuypers HTM, Van Oostendrop WR, Lelie PN, van der Poel CL et al. New hepatitis B virus mutant form in a blood donor that is undetectable in several hepatitis B surface antigen screening assays. Transfus. 1998;38:56-9.

Kant L, Arora NK. Transmission of hepatitis B virus in children: Indian scenario. Hepatitis B in India: Problems and prevention. 1996;1:21-32.