Is the apparent outbreak of hepatitis A in Belgian hemophiliacs due to a loss of previous passive immunity?
Several reports describing outbreaks of hepatitis A in hemophilia A patients transfused with solvent/detergent-treated factor VIII concentrates have raised concern about possible transmission of hepatitis A by these concentrates. We recently witnessed such an outbreak of hepatitis A in 6 hemophilia A patients; review of the clinical data did not disclose any increased risk factor for community-acquired hepatitis A. A case-control study comparing the prevalence of anti-hepatitis A IgG antibodies in hemophiliacs and age-matched controls showed a lower seroprevalence in hemophiliacs. This might be due to passive protection acquired through transfusion of the previously used immunoglobulin-containing cryoprecipitate. The outbreak of hepatitis A could be explained as a catch-up phenomenon linked to the loss of passive protection with the use of purer factor VIII concentrates.
Peerlinck
K
K
Center for Molecular and Vascular Biology, University Hospitals of Leuven, Belgium.
Goubau
P
P
Coppens
G
G
Desmyter
J
J
Vermylen
J
J
D000293:Adolescent; D000328:Adult; D001530:Belgium / Q000453:epidemiology; D016913:Blood Component Transfusion / Q000009:adverse effects*; D016022:Case-Control Studies; D004196:Disease Outbreaks; D005169:Factor VIII / Q000009:adverse effects; D006467:Hemophilia A / Q000276:immunology / Q000628:therapy*; D006506:Hepatitis A / Q000453:epidemiology* / Q000276:immunology* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies
D005169:Factor VIII