Prevalence of hepatitis C antibodies in patients with clotting disorders in Victoria. Relationship with other blood borne viruses and liver disease.
OBJECTIVE
To elucidate the seroepidemiology of hepatitis C in patients with clotting disorders in comparison with other blood borne infections; to examine the effects of hepatitis C on liver function; and to assess the effectiveness of current screening and inactivation procedures used in preventing the transmission of blood borne viruses by clotting factor preparations.


METHODS
A retrospective analysis of the prevalence of antibodies to hepatitis C virus (HCV), hepatitis B virus (HBV) and human immunodeficiency virus (HIV) by means of commercially available enzyme immunoassays (for antibodies to HCV and HIV) or radioimmunoassays (for HBV antibodies and surface antigen). An analysis was made of serum transaminase levels where such information was available and this was correlated with HCV status.


METHODS
Panels of sera were collected from adults and children with clotting disorders attending two Melbourne haemophilia treatment centres in 1973 (n = 33), 1980 (n = 33), 1984-1985 (n = 111) and 1987-1990 (n = 217) and tested for antibodies to HCV, HBV and HIV.


RESULTS
The prevalence of antibodies to HCV in the four panels tested was 45%, 74%, 75% and 76%, and the prevalence of markers of infection with HBV was 66%, 74%, 62% and 65% respectively. No antibodies to HIV were found in sera in Panels I and II but the prevalence in Panels III and IV was 23% and 36% respectively. In subjects in whom liver function test results were available, there was a significant association between the presence of antibodies to HCV and raised transaminase levels. Since heat inactivation of clotting factors was commenced in Australia in 1984, no new cases of transmission of HIV by clotting factors has been detected, but transmission of HCV in 19 subjects and HBV in one subject could not be excluded.


CONCLUSIONS
Hepatitis C infection in haemophiliacs has been a very frequent event, and the presence of antibodies to HCV is associated with an increased incidence of raised transaminase levels. Screening and heat inactivation of clotting factors has prevented further HIV transmission, but exposure to HBV and HCV has not been eliminated.
Leslie
D E
DE
Virus Laboratory, Fairfield Hospital, Vic.
Rann
S
S
Nicholson
S
S
Fairley
C K
CK
Gust
I D
ID
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001778:Blood Coagulation Disorders / Q000150:complications / Q000276:immunology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D015483:HIV Antibodies / Q000032:analysis; D006467:Hemophilia A / Q000150:complications / Q000276:immunology / Q000503:physiopathology; D006474:Hemorrhagic Disorders / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D016174:Hepacivirus / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000032:analysis*; D006509:Hepatitis B / Q000150:complications; D006510:Hepatitis B Antibodies / Q000032:analysis; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014739:Victoria / Q000453:epidemiology
D015483:HIV Antibodies; D006508:Hepatitis Antibodies; D006510:Hepatitis B Antibodies