Hepatitis C infection and viremia in Dutch hemophilia patients.
Serum samples from 316 patients visiting the Dutch National Hemophilia Center were collected from 1979 to 1993 and stored at -30 degrees C. Patients were placed into three different groups: 1) patients ever treated with large pool non-hepatitis C virus (HCV)-safe concentrate (n = 179); 2) patients treated with cryoprecipitate (n = 125); and 3) patients treated exclusively with HCV-save concentrate (n = 12). In order to examine the prevalence of HCV infection in the different treatment groups serum samples were tested retrospectively for anti-HCV antibody using second generation enzyme-linked immunosorbent assay (ELISA) and recombinant immunoblot assay (RIBA-2). Significant differences in the prevalence of HCV infection were found between these 3 groups (group 1: 99%, group 2: 66%, group 3: 0%). The safety of currently administered clotting products is demonstrated in 57 patients who remained without HCV markers between 1989 and 1993. To examine the natural course of HCV infection fresh-frozen plasma samples were obtained recently from a subgroup of 277 hemophilia patients for HCV-RNA detection by a well-validated cDNA-PCR assay. In contrast to other reports, no evidence was found for seronegative HCV carriers. None of 52 patients without anti-HCV had detectable HCV-RNA. Of 225 patients with anti-HCV, 182 (81%) were HCV-RNA positive. None of 39 anti-HCV positive patients with a negative HCV-RNA reaction had serum alanine aminotransferase (ALT) levels above 50 U/l, whereas 44% of HCV-RNA positive patients had persistently elevated ATL levels above 50 U/l.(ABSTRACT TRUNCATED AT 250 WORDS)
Mauser-Bunschoten
E P
EP
Van Creveld Clinic, University Hospital Utrecht, The Netherlands.
Bresters
D
D
van Drimmelen
A A
AA
Roosendaal
G
G
Cuypers
H T
HT
Reesink
H W
HW
van der Poel
C L
CL
van den Berg
H M
HM
Lelie
P N
PN
D000410:Alanine Transaminase / Q000097:blood; D001779:Blood Coagulation Factors / Q000009:adverse effects / Q000302:isolation & purification; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D004340:Drug Contamination; D006467:Hemophilia A / Q000150:complications*; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006508:Hepatitis Antibodies / Q000097:blood; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology / Q000635:transmission; D018937:Hepatitis C Antibodies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D014766:Viremia / Q000150:complications* / Q000453:epidemiology
D001779:Blood Coagulation Factors; D004279:DNA, Viral; D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D000410:Alanine Transaminase