A multicenter study of viral hepatitis in a United States hemophilic population.
Hemophilia A and B patients seen at nine US regional treatment centers were tested for serologic markers of hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis delta virus (HDV) during 1987 and 1988. Because human immunodeficiency virus (HIV) infection, a potentially confounding variable, was present in 53% of the group, the population was divided by HIV status for analysis purposes. In the HIV-positive group (N = 382), less than 1% had not been infected with HBV, HCV, or HDV, whereas 75% had evidence of infection with HBV and 98% with HCV. HBsAg, a marker of active HBV infection, was present in 12% of subjects; 96% of these were HCV positive. Anti-HDV was detected in 35 subjects (9.1%); all were anti-HBc positive. Ten of the 35 (29%) also were positive for IgM anti-HDV, indicating current infection. All 10 were HBsAg positive and 7 of the 9 tested were HDV RNA positive. Severe/moderate hemophilia B patients were more likely to have experienced an HBV infection and to be anti-HDV positive than were similar hemophilia A patients (22% v 8%, P < .05). In the HIV-negative group (N = 345), the subjects were younger and had less severe hemophilia than the HIV-positive patients. No evidence of HBV, HCV, or HDV infection was found in 18%, whereas 33% had experienced HBV infection and 79% were anti-HCV positive. Within this group, 4% were HBsAg positive. All 13 subjects with anti-HDV (4% of the HIV-negative group) also possessed anti-HBc. One (7.7%) was IgM anti-HDV positive and the serum from another contained HDV RNA. Both of these individuals were HBsAg positive. As in the HIV-positive group, severe/moderate hemophilia B patients were more likely to be HBV and HDV positive than were hemophilia A patients (9% v 3%, P < .05). A prevalence study of viral hepatitis in a large US hemophilic population showed that active infection with HCV is common, occurring in 89% of all study patients regardless of HIV status. Evidence of active HBV infection was found in 8%; 19% of these were actively infected with HDV. HDV was more common in hemophilia B patients after controlling for disease severity.
Troisi
C L
CL
Baylor College of Medicine, Houston, TX 77030.
Hollinger
F B
FB
Hoots
W K
WK
Contant
C
C
Gill
J
J
Ragni
M
M
Parmley
R
R
Sexauer
C
C
Gomperts
E
E
Buchanan
G
G
D000328:Adult; D006679:HIV Seropositivity / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D006467:Hemophilia A / Q000097:blood / Q000150:complications*; D002836:Hemophilia B / Q000097:blood / Q000150:complications*; D006508:Hepatitis Antibodies / Q000097:blood; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D018937:Hepatitis C Antibodies; D003699:Hepatitis D / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D003698:Hepatitis Delta Virus / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D012367:RNA, Viral / Q000097:blood; D014481:United States / Q000453:epidemiology
D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D007075:Immunoglobulin M; D012367:RNA, Viral