Vaccination Against Hepatitis A for Hemophilic Patients: Is It Necessary?

Background: hemophilic patients require long-life intravenous infusion of factor concentrates to treat bleedings. this could increase the risk of transmission of blood-borne infections like hepatitis c. objectives: the current study was aimed at investigating the immunity status against hepatitis a in hemophilic patients in south khorasan and evaluating the necessity of hepatitis a vaccination for this population. patients and methods: a cross-sectional descriptive study was conducted between 2014 and 2015 on all hemophilic patients of south khorasan province, iran (n = 108) for anti-hav total, anti-hcv, hbs-ag, anti-hiv, and anti-htlv-i /ii. note that no one had already received a hepatitis a vaccine. results: as our results show, 77.8% of the participants (59% under 20 and 88.4% above 20 years old) were seropositive for anti-hav total; 20.4% and 2.8% (three patients) of the cases were anti-hcv positive and anti-htlv-1 positive, respectively, while none of the subjects were hbs-ag or hiv-ab positive. seventeen of the patients (15.75%) showed a co-infection of hav with hcv, and five hcv infected patients (22.73%) had no immunity against hepatitis a. there was a significant relationship between age, rural life, and anti-hav positive state in our patients (p < 0.001). no significant relationship between positive anti-hav status and sex (p = 0.16), severity of hemophilia (p = 0.23), and infection with hiv, hcv, htlv-1, and hepatitis b (p > 0.05) was detected. conclusions: more than 40% of the hemophilic patients under 20 years of age in the present study had no immunity against hepatitis a, and 23% of hepatitis c patients had not had a hepatitis a co-infection yet. since hepatitis a can show a fulminant course in hepatitis c patients, vaccination against hepatitis a seems necessary in hemophilic patients in the region.