Haemophilia a patients are not at increased risk of hepatitis a virus infection : an Egyptian experience

الملخص EN

Background : Hepatitis A virus (HAV) infection is endemic in Egypt.

Hemophiliacs are at risk of transmission through exposure to blood products.

We evaluated the seroprevalence of hepatitis A in Egyptian patients with haemophilia A as well as the safety and immunogenicity of subcutaneous hepatitis A vaccine in hemophiliacs'.

Methods : 182 male children and adolescents were studied (82 patients with moderate and severe haemophilia A and 100 healthy controls).

Screening for anti-HAV antibody was done and seronegative subjects received hepatitis A vaccine (Havri at a dose of 720 Elisa Units at 0 and 6 months, given subcutaneously in hemophiliacs' and intramuscularly for controls.

Seroconversion was assessed 2 months after the second vaccine dose by anti-HAV IgG.

Results : seroprevalence of HAV antibodies was 87.6 % among hemophiliacs and 90 % among the control group.

Seronegative children (mean age 4.4 ± 3.71 years) were significantly younger than seropositive children (mean age 10.2 ± 3.86 years).

Hepatitis A vaccine was given to 10 non immune haemophilia patients and 10 controls.

The vaccine was well tolerated with local side effects including pain in 40 % and erythema in 20 % of hemophiliacs' versus 20 % for pain and erythema in the control group.

All patients and controls developed seroconversion 2 months after the second dose ; with no significant difference as regards the titre of anti-HAV IgG (351.4 ± 65.0 IU / L for hemophiliacs and 367.0 ± 132.3 IU / L for controls Conclusion : HAV infection occurs early in life in Egyptian children, necessitating hepatitis A vaccination in early life.

The vaccine is safe and effective when given subcutaneous in hemophiliacs'.