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Transfusion-transmitted infection in hemophilia in developing countries
Thynn Thynn Yee1, Christine A Lee
1Haemophilia Centre and Haemostasis Unit, The Royal Free Hospital, London, United Kingdom.
Seminars in Thrombosis and Hemostasis
|November 9, 2005
Summary
Blood transfusions for hemophilia patients can transmit viruses like hepatitis C (HCV) and HIV. While modern treatments reduce risk, developing nations still face challenges with these blood-borne infections and access to care.
Area of Science:
- Hematology
- Virology
- Public Health
Background:
- Blood products used in treating bleeding disorders, particularly hemophilia, have historically been associated with transmission of blood-borne viruses.
- Hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) have posed significant health risks to hemophiliacs.
- While virus-inactivation methods have minimized risks in factor concentrates since 1985, challenges persist in developing countries lacking access to these advanced treatments.
Purpose of the Study:
- To review the historical and ongoing risks of blood-borne viral infections in hemophilia patients.
- To highlight the disparities in access to safe blood products and treatments between developed and developing countries.
- To discuss the long-term health consequences of HCV and HIV coinfection in hemophiliacs and the progress in managing these infections.
Main Methods:
- Literature review of studies on blood-borne viral infections in hemophilia patients.
- Analysis of historical data on the prevalence of HBV, HCV, and HIV in hemophiliac populations.
- Examination of the impact of virus-inactivation technologies and antiretroviral therapies.
Main Results:
- HCV infection frequently leads to liver damage and cirrhosis in hemophiliacs, with spontaneous clearance rare.
- HIV coinfection significantly reduces life expectancy in hemophiliacs.
- While developed countries saw a major HIV epidemic in hemophiliacs in the mid-1980s due to pooled plasma concentrates, developing countries have lower rates, influenced by plasma source.
- Advancements in factor concentrate purification and antiretroviral treatments offer improved outcomes, but challenges remain.
Conclusions:
- Despite progress in viral inactivation and treatment, blood-borne infections remain a critical concern for hemophiliacs, especially in resource-limited settings.
- Ensuring access to safe factor concentrates and effective antiretroviral therapy is crucial for mitigating the long-term health impact of HCV and HIV in this population.
- Further efforts are needed to address the challenges in delivering comprehensive care and to fully understand the long-term consequences of these transmitted infections.