Abstract

Prevalence of HIV and other transfusion-transmitted coinfections among hemophiliac patients in Brazil

R.A. Carmo, M.S.d. Oliveira

Hemominas Foundation, Infectious Diseases Service, Belo Horizonte, Brazil

Background: Treatment of hemophiliacs with blood products has been associated with HIV and other transfusion-transmitted infections (TTI). The risk remained in emerging and developing countries, like Brazil, where the use of inactivated clotting factor concentrates was very restricted until the late eighties. The aim of this study was to determine the prevalence of HIV infection (anti-HIV) and coinfection with HCV (anti-HCV), HBV (anti-HBc), HTLV-I/II (anti-HTLV-I/II), syphilis (VDRL) and Chagas's disease (anti-T. cruzi) among hemophiliacs in Brazil.
Methods: Sociodemografic , clinical and serological data were retrospectively collected from medical charts of all hemophiliacs attending the main public blood center in the State of Minas Gerais, Brazil, between January 1985 and January 2008. Each patient was tested for TTI at least twice a year. Odds ratios were determined and compared between HIV positive and negative patients.
Results: In the period of the study, 664 hemophiliacs had received medical assistance in the blood center. Most patients were 25 or older (50.5%), male (98.7%), non-white (69.7%) and single (84.2%). HIV infection was detected in 66 hemophiliacs (10.1%). All the HIV+ hemophiliacs (100%) had received whole blood or some blood product (plasma and/or cryoprecipitate) without any viral inactivation in their lifetime. Twenty nine patients (43.9%) were alive in January 2008. Among HIV+ hemophiliacs, 47 (71.2%) were coinfected with HCV (OR=5.78 [95%CI: 3.29-10.13]) and 34 (51.6%) have tested positive for HBV (OR=3.81 [95%CI: 2.26-6.42]). Serologic markers for other TTI were observed in seven HIV+ hemophiliacs (10.6%) for HTLV-I/II (OR=5.27 [95%CI: 2.03-13.72], six (9.1%) for syphilis (OR=9.68 [95%CI: 3.03-30.96]) and two (3.0%) for Chagas's disease (OR=2.26 [95%CI: 0.47-10.89]).
Conclusions: Elevated rates of HIV infection and HCV and HBV coinfections were found. These results confirm the importance of screening for HIV and other TTI among hemophiliacs.