title: Risk of hepatitis A in Dutch hemophilia patients.
abstract: Recently, clotting factor preparations transmitted hepatitis A virus (HAV) to hemophilia patients. To study the risk of HAV infection in Dutch hemophilia patients, serum samples of 341 patients with hemophilia were tested for HAV antibodies (anti-HAV). 197/341 patients (group 1) were treated with clotting factor concentrates produced from large plasma pools, 144/341 patients (group 2) were treated with small pool cryoprecipitate. The test results were compared to those of healthy blood donors (n = 19,746) of the same age. In addition stored serum samples (1983-1994) from hemophilia patients were tested for HAV antibodies. No increased risk of HAV infection was found in Dutch hemophilia patients. The anti-HAV prevalence in group 1 was 20%, in group 2 13% and in blood donors 41%. A significantly (p < 0.002) lower percentage of HAV antibodies was found in hemophilia patients born in the 1950s using cryoprecipitate (11%) as compared to blood donors of the same age (40%), probably caused by passive administration of anti-HAV through clotting product. Passive immunization in the past was significantly (p < 0.02) more often found in group 2 (41.7%) than in group 1 (28%). In the period 1983 till 1988 five seroconversions were seen in group 1 (2%) and one in group 2 (0.7%). Anti-HAV seroconversions were not observed after 1988. In a risk analysis we estimated that 2 plasma pools of 10,000 Dutch blood donors per year may contain HAV. The absence of HAV among Dutch hemophilia patients suggests that this contamination is successfully inactivated.
authors.affiliation: Van Creveld Clinic, University Hospital Utrecht, The Netherlands.
authors.forename: E P
authors.initials: EP
authors.lastname: Mauser-Bunschoten
authors.forename: H L
authors.initials: HL
authors.lastname: Zaaijer
authors.forename: A A
authors.initials: AA
authors.lastname: van Drimmelen
authors.forename: H M
authors.initials: HM
authors.lastname: van den Berg
authors.forename: G
authors.initials: G
authors.lastname: Roosendaal
authors.forename: P N
authors.initials: PN
authors.lastname: Lelie
mesh_terms: D001779:Blood Coagulation Factors / Q000009:adverse effects; D001782:Blood Donors; D015897:Comorbidity; D006467:Hemophilia A / Q000453:epidemiology*; D006506:Hepatitis A / Q000453:epidemiology* / Q000517:prevention & control; D035922:Hepatitis A Antibodies; D006508:Hepatitis Antibodies / Q000097:blood*; D006801:Humans; D007116:Immunization, Passive; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012306:Risk; D018570:Risk Assessment; D016036:Seroepidemiologic Studies; D065227:Transfusion Reaction; D014842:von Willebrand Diseases / Q000453:epidemiology*
chemical_list: D001779:Blood Coagulation Factors; D035922:Hepatitis A Antibodies; D006508:Hepatitis Antibodies