الفهرس | Only 14 pages are availabe for public view |
Abstract c hronic Hepatitis C virus is usually associated with the presence of autoantibodies (Zohreh and Seyed, 2010). Acquired hemophilia A (AHA) is an autoimmune disease caused by an antibody that inhibits the action of factor VIII resulting in coagulopathy and bleeding (Collins et al., 2010). Diagnosis of acquired hemophilia can be difficult (Franchini et al., 2005). The typical findings of acquired hemophilia are a prolonged activated partial thromboplastin time (APTT) and a low activity of coagulation factors, Mixing studies can be used to demonstrate the presence of a time-dependent inhibitor of coagulation factors (Kitchen et al., 2010). Therefore, it is not unexpected that autoantibodies to factor VIII be found in patients infected with the hepatitis C virus. This inhibition is due to autoantibodies against coagulation factor VIII (Schreiber and Bräu, 2005). The aim of the current study was to assess the prevalence of acquired hemophilia in hepatitis C virus infection The exploratory study was conducted on 65 patients with chronic hepatitis C viral infection. They were selected from the inpatient wards and outpatient clinics of Ain Shams University Hospital. The studied sample was on patients with prolonged PT and PTT and was 18 years old or more. We excluded those who had other causes of chronic liver disease, other autoimmune disease, and other causes of chronic infection and patients with past or family history of bleeding Each patient was subjected to: PT and PTT test, Mixing test was done with normal plasma for PT and PTT and Factor VIII activity was tested to explore factor VIII deficiency in these patients. It was found in our study that PTT was prolonged by mixing test among 17% of HCV patients, normal factor VIII activity exclude the presence of acquired hemophilia A. This means that there were auto antibodies which may be either antiphospholipid syndrome or inhibitors of coagulation factors (factor IX, vWF). The rest of patients had prolonged PT and PTT but corrected by mixing test with normal plasma this exclude the presence of autoantibodies in these patients. Mostly prolonged PT and PTT in those patients is due to vitamin K dependent factors deficiency |