Person with Hemophilia & Hepatitis
Hepatitis is an inflammation of the liver that occurs when the liver is injured or infected. It can range from being asymptomatic to becoming a life-threatening condition. Symptoms may include fatigue, nausea, vomiting, muscle and joint aches, liver tenderness and enlargement and/or weight loss. Hepatitis can be acute (lasting less than six months) or chronic. It occurs commonly throughout the world.
Hepatitis can be caused by any substance that damages the liver, including alcohol, drugs, chemicals, viruses or a combination of any of these. Hepatitis caused by viruses is called viral hepatitis and can be transmitted through blood and blood products.
Six different viruses are now known to cause hepatitis—hepatitis A, B, C, D, E and G. Hepatitis A, B and C account for almost 95% of all cases of viral hepatitis. The other strains are uncommon.
Though blood safety techniques have become highly advanced but are still not adopted as a must by all blood banks. Whole blood and blood components, including packed red blood cells, platelets and cryoprecipitate cannot be treated 100% with currently available virus-killing methods. Plasma may now be created with the same virus-killing methods (solvent-detergent plasma) used for hemophilia products. This is because these methods would damage or inactivate important blood components, making these blood products useless.
Therefore, only high quality Factor Concentrates or Recombinant Factors should be used.
As a health precaution, it is advised that persons with bleeding disorders get vaccines against both hepatitis A and hepatitis B. They should also be tested for hepatitis C on a yearly basis. There is, however, no vaccine for hepatitis C.
Prevention
High-risk activity that may lead to the transmission of hepatitis includes direct sexual contact with an infected person, sharing needles and coming into contact with infected blood. In some cases of hepatitis, little is known about how the infection is acquired.
Good hygiene helps prevent the spread of hepatitis A. Because the stool of people with hepatitis A is infectious, stool samples must be handled with special care. The same is true for the blood of people with any type of acute hepatitis. On the other hand, infected people don't require isolation—it does little to prevent the transmission of hepatitis A, and it won't prevent the transmission of hepatitis B or C.
Vaccinations are available against hepatitis A and B. Vaccination is especially important for people at risk for contracting hepatitis B, though it isn't effective once the disease is established. For these various reasons, universal vaccination of all people against hepatitis B is being increasingly recommended.
Hepatitis B vaccine is recommended for all children by the American Academy of Paediatrics. Hepatitis A vaccine is recommended for all individuals two years of age and older with hemophilia and other congenital bleeding disorders.
Hepatitis A vaccines are given to people who are at a high risk of acquiring the infection, such as travelers to parts of the world where the disease is widespread. No vaccines are available against the hepatitis C, D and E viruses.
People who haven't been vaccinated and are exposed to hepatitis may receive an antibody preparation (immune serum globulin) for protection.
The infection can be detected by simple, routine blood tests performed by doctors who suspect infection. Unfortunately, many people with hepatitis are never tested because they have no symptoms; by the time their infection is discovered, serious liver damage may have occurred. If someone thinks he or she may be infected, a doctor should be seen as soon as possible
- Hepatitis A rarely if ever becomes chronic.
- Hepatitis B becomes chronic in 5 to 10 percent of the infected people and can be mild or full-blown.
- Hepatitis C has the greatest likelihood of becoming chronic—about a 70% chance. About one-third of chronic carriers have normal liver enzymes, and 70% will persist with elevated liver enzymes.
Though usually mild and often without symptoms, hepatitis C is a serious problem because about 20% of the infected people may eventually develop cirrhosis of the liver.
Around 30% of persons with hemophilia in India are suspected of HCV infection. The treatment cost is again very high and not affordable. A person suffering with hemophilia if simultaneously infected with HCV is a killing experience and beyond explanation.
It is, therefore, very important for doctors to prescribe high quality Factors with full support from the State & Central Governments.
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