A study in respect of transfusion related complications in hemophiliacs with special reference to developing factor inhibitors

Abstract

Prophylaxis and treatment with factor replacement have greatly improved the quality of care for patients with hemophilia.However,development of factor inhibitors is the most serious and challenging complication of therapy. Other complications are viral infections like Hepatitis B, Hepatitis C, and HIV, and the other infective diseases, which can be transmitted by the blood and blood products transfusion.The aims of this study is to study the complications in the hemophiliacs who have been treated prophylactically or ‘on demand’ with fresh frozen plasma, cryoprecipitate and concentrated products of FVIII andDuring the study period, all patients (100) with Hemophilia attending Gandhi Medical College are taken under consideration. The presence of an inhibitor was determined by a simple mixing experiment using the test plasma and normal pooled plasma and 3 generation enzyme linked immunosorbent assay (ELISA) method& anti-HBsAg.statisticalThe inhibitor study showed that in 7%(3.2-13.98 at 95% confidence interval) patients, APTT was not corrected after mixing patients plasma with pooled normal plasma (PNP) and applying the test immediately and after one hour of incubation. serological tests showed antibodies for HCV were positive in 4% of cases (1.1%-9.93% at 95% CI), whereas antibodies against HBsAg was positive in 1% of cases(0.3%-5.45% at 95% CI), which was less then anti HCV. Transfusion associated complications were higher in severe form of Haemophilia as compared to moderate and mild form of Hemophilia.Developing antibodies to infused factor concentrates (inhibitors) remains a major source of morbidity and mortality in the treatment of patients with hemophilia. Novel treatment approaches for these patients are in developmental stage, which include therapeutic agents that mimic factor VIII or augment thrombin production by bypassing the inhibitors, as well as agents that act by inhibiting the natural anticoagulants.