Gharoonpour Azar, Maleki Saeideh, Sharifi Hamid, Osia Seyedehsara, Sharafi Heidar, Keshvari Maryam
Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran 1419733141, Iran.
Middle East Liver Diseases (MELD) Center, Tehran 1598976513, Iran.
Pathogens. 2023 Apr 4;12(4):555. doi: 10.3390/pathogens12040555.
Patients with hereditary bleeding disorders (HBDs) have always been vulnerable to transfusion-transmitted infections (TTIs) such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections due to being regular recipients of blood and blood products. This study aimed to detect the trends in the prevalence of HBV, HCV, and HIV infections by birthyear in Iranian patients with HBDs to show the efficacy of national interventions implemented to administrate control and to prevent these infections, i.e., blood safety, newborn HBV vaccination, and safe replacement treatments.
In this retrospective study, the trends in the prevalence of hepatitis B core antibody (HBcAb), HCV antibody (HCV-Ab), and HIV antibody (HIV-Ab) in Iranian patients with HBDs born before 2012 were assessed using patients' clinical archives. The determinants of HBV, HCV, and HIV infections were investigated in bivariable and multivariable logistic regression analyses.
Out of 1475 patients with HBDs, most were male (87.7%) and diagnosed with hemophilia A (52.1%) and severe bleeding disorder (63.7%). The prevalence of HBcAb, HCV-Ab, and confirmed HIV-Ab was 22.9%, 59.8%, and 1.2%, respectively. The trends in HBcAb, HCV-Ab, and HIV-Ab were all decreasing by birthyear and reached a stable level of 0% for patients with birthyears in 1999, 2000, and 1984, respectively. In multivariable analysis, birthyear was significantly associated with HBcAb prevalence. In the multivariable analysis, type of HBD; birthyear; bleeding severity; histories of receiving packed cells, fresh frozen plasma, and cryoprecipitate before 1996; and history of receiving factor concentrate before 1997 were highly associated with the prevalence of HCV-Ab. Moreover, in the bivariable analysis, birthyear and type of HBD were associated with HIV-Ab prevalence.
This study demonstrated the decreasing trends in HBV, HCV, and HIV seroprevalence in Iranian patients with HBDs following preventive interventions such as HBV vaccination, blood safety measures, and the provision of safe replacement treatments.
遗传性出血性疾病（HBD）患者由于经常接受血液和血液制品，一直易受输血传播感染（TTI），如乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）感染。本研究旨在检测伊朗HBD患者中按出生年份划分的HBV、HCV和HIV感染流行趋势，以显示为实施控制和预防这些感染而采取的国家干预措施的效果，即血液安全、新生儿HBV疫苗接种和安全替代治疗。
在这项回顾性研究中，利用患者的临床档案评估了2012年之前出生的伊朗HBD患者中乙型肝炎核心抗体（HBcAb）、HCV抗体（HCV-Ab）和HIV抗体（HIV-Ab）的流行趋势。在双变量和多变量逻辑回归分析中研究了HBV、HCV和HIV感染的决定因素。
在1475例HBD患者中，大多数为男性（87.7%），诊断为甲型血友病（52.1%）和严重出血性疾病（63.7%）。HBcAb、HCV-Ab和确诊的HIV-Ab流行率分别为22.9%、59.8%和1.2%。HBcAb、HCV-Ab和HIV-Ab的流行趋势均随出生年份下降，出生年份分别为1999年、2000年和1984年的患者分别达到0%的稳定水平。在多变量分析中，出生年份与HBcAb流行率显著相关。在多变量分析中，HBD类型；出生年份；出血严重程度；1996年之前接受浓缩红细胞、新鲜冰冻血浆和冷沉淀的病史；以及1997年之前接受凝血因子浓缩物的病史与HCV-Ab流行率高度相关。此外，在双变量分析中，出生年份和HBD类型与HIV-Ab流行率相关。
本研究表明，在采取如HBV疫苗接种、血液安全措施和提供安全替代治疗等预防干预措施后，伊朗HBD患者中HBV、HCV和HIV血清流行率呈下降趋势。
