Hepatitis C infection in children with hemophilia A and B
VS Blanchette, E Vorstman, A Shore, E Wang, M Petric, BW Jett and HJ Alter
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario,
Canada.
Antibodies to hepatitis C virus (anti-HCV) were quantitated in stored sera
from selected groups of hemophilic children (less than or equal to 18 years
of age). During the period 1987 to 1989, seropositivity rates were as
follows: untransfused hemophiliacs 0% (0 of 11 cases), hemophiliacs treated
exclusively with vapor-heated factor VIII or IX concentrates 0% (0 of 9
cases), hemophiliacs treated only with cryoprecipitate or single donor
blood products 0% (0 of 9 cases), and hemophiliacs regularly treated with
unheated or dry heat-treated factor VIII or IX concentrates 95% (21 of 22
cases). Corresponding alanine aminotransferase (ALT) results were similar:
values were always below the upper limit of laboratory normal (40 U/L) in
untransfused hemophiliacs, hemophiliacs treated with vapor-heated factor
concentrates, or those who received only cryoprecipitate or single donor
blood products. By contrast ALT values were greater than 40 U/L in 82% (18
of 22 cases) of hemophilic children regularly infused with unheated or dry
heat-treated factor concentrates. Three conclusions are drawn from this
data: (1) HCV is a major cause of chronic hepatitis in multitransfused
hemophilic children, (2) unheated and dry heat-treated clotting factor
concentrates carry a very high risk of transmitting HCV infection, and (3)
clotting factor concentrates inactivated by vapor heating carry a very low
and perhaps zero risk of transmitting HCV infection. These findings are of
therapeutic significance for previously untransfused hemophiliacs
susceptible to HCV infection.
Volume 78,
Issue 2,
pp. 285-289,
07/15/1991
Copyright © 1991 by The American Society of Hematology
