Hepatitis C virus infection among Brazilian hemophiliacs: a virological, clinical and epidemiological study.
We determined and analyzed risk factors of hepatitis C virus (HCV)-infected Brazilian hemophiliacs according to their virological, clinical and epidemiological characteristics. A cross-sectional and retrospective study of 469 hemophiliacs was carried out at a Brazilian blood center starting in October 1997. The prevalence of HCV infection, HCV genotypes and factors associated with HCV RNA detection was determined. The seroprevalence of anti-HCV antibodies (ELISA-3.0) was 44.6% (209/469). Virological, clinical and epidemiological assessments were completed for 162 positive patients. There were seven (4.3%) anti-HCV seroconversions between October 1992 and October 1997. During the same period, 40.8% of the positive anti-HCV hemophiliacs had abnormal alanine transaminase (ALT) levels. Plasma HCV RNA was detected by nested-RT-PCR in 116 patients (71.6%). RFLP analysis showed the following genotype distribution: HCV-1 in 98 hemophiliacs (84.5%), HCV-3 in ten (8.6%), HCV-4 in three (2.6%), HCV-2 in one (0.9%), and not typeable in four cases (3.4%). Univariate analysis indicated that older age (P = 0.017) and abnormal ALT levels (P = 0.010) were associated with HCV viremia, while the presence of inhibitor antibodies (P = 0.024) and HBsAg (P = 0.007) represented a protective factor against the presence of HCV RNA. These findings may contribute to a better understanding of the relationship between HCV infection and hemophilia.
Carmo
R A
RA
Fundação Hemominas, Alameda Ezequiel Dias 321, 30130-110 Belo Horizonte, MG, Brazil. ricarmo@net.em.com.br
Oliveira
G C
GC
Guimarães
M D C
MD
Oliveira
M S
MS
Lima
A A
AA
Buzek
S C
SC
Corrêa-Oliveira
R
R
Rocha
M O C
MO
D000328:Adult; D000704:Analysis of Variance; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005838:Genotype; D006467:Hemophilia A / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D006801:Humans; D008297:Male; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors
D012367:RNA, Viral