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pmid: 20590855
Summary. Despite continuous improvement in safety and purity of blood products for individuals with haemophilia, transmissible agents continue to affect individuals with haemophilia. This chapter addresses three viral pathogens with significant clinical impact: HIV, hepatitis C and parvovirus B19. Hepatitis C is the leading cause of chronic hepatitis and the major co‐morbid complication of haemophilia treatment. Clinically, asymptomatic intermittent alanine aminotransferase elevation is typical, with biopsy evidence of advanced fibrosis currently in 25%. Current treatment is effective in up to 70%, and many new agents are in development. For those progressing to end‐stage liver disease, liver transplantation outcomes are similar to those in non‐haemophilia subjects, although pretransplant mortality is higher. HIV infection, the second leading co‐morbid condition in haemophilia, is managed as a chronic infection with highly active antiretroviral therapy (HAART). HAART also slows hepatitis C virus (HCV) progression in those with HIV/HCV co‐infection. Viral inactivation and recombinant technologies have effectively prevented transfusion‐transmitted viral pathogens in haemophilia. Human parvovirus B19 infection, typically associated with anaemia or, rarely severe aplastic crisis, is a non‐lipid enveloped virus, for which standard inactivation techniques are ineffective. Thus, nucleic acid testing (NAT) to screen the blood supply for B19 DNA is currently under consideration by the Food and Drug Administration. To the extent, viral inactivation, recombinant, and NAT technologies are available worldwide, and the lifespan for those with haemophilia is approaching that of the normal population. The purpose of this chapter is to provide an update on three clinically significant transfusion‐transmitted viral pathogens.
Liver Cirrhosis, Transfusion Reaction, HIV Infections, Hepacivirus, Hepatitis C, Chronic, Hemophilia A, Antiviral Agents, Hepatitis C, Liver Transplantation, Parvoviridae Infections, Parvovirus B19, Human, Humans
Liver Cirrhosis, Transfusion Reaction, HIV Infections, Hepacivirus, Hepatitis C, Chronic, Hemophilia A, Antiviral Agents, Hepatitis C, Liver Transplantation, Parvoviridae Infections, Parvovirus B19, Human, Humans
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influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Top 10% | |
impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Top 10% |