Coinfection of Hepatitis B and C with Human Immunodeficiency Virus in Hemophilia: A Cross Sectional Study

Aims: To identify coinfection by Hepatitis B (HBV), Hepatitis C (HCV) and Human immunodeficiency virus (HIV) in Hemophiliacs.

Methodology: We included 107 hemophiliacs. For the current analysis, age, type, severity of Hemophilia and serum profile for Hepatitis B, C and HIV were included. The serological tests performed for Hepatitis and HIV were carried out using the enzyme-linked immunosorbent assay method (ELISA) and the confirmatory tests for HIV and HCV were done by the Western Blot and Polymerase Chain Reaction (PCR). The results of positive and negative serology were compared using the Mann-Whitney test using the Fundação Hemominas reproducibility map of serological reactions, through the CUT-off of each test.

Study Design: A cross-sectional study was carried out on hemophilics to asses the prevalence of infections diseases transmitted by transfusion.

Place and Duration of Study: Department of Hematology, public service on Coagulopathies at Fundação Hemominas Juiz de Fora Brazil, between January 2008 to December 2018.

Results: The average age was 32.77 years with standard deviation (SD)= 16.8 years. In regard to classification, 57.65% of patients with Hemophilia A were severe, and 57% of patients with Hemophilia B were moderate. Laboratory results demonstrated that 24.3% of the patients were HBV positive, and 40.2% were HCV positive, with 21.42% positive by PCR. The prevalence of HIV positive was 11.2%. In general analysis, 44.82% had at least one type of viral infection and 23.4% presented coinfections. HIV positive patients were all positive for HCV (11.2%) and 7.5% of patients were infected by HIV, HCV and HBV. The coexistence of hepatitis C and HIV was statistically relevant with (P = .001), considering the year of birth, most patients with HCV and HIV were born before 1980s (P = .001).

Conclusions: Infections by HBV, HCV and HIV are late complications in patients that received blood products before 1990s. Infection by a viral agent and the year of birth has a direct association, due to the standardization and implantation of tests for HIV and HCV in the 80s and 90s.