1 ЭМШУИС, Био-анагаахын сургууль, 2 УКТЭ, Цусны эмгэг судлалын тасаг, 3Монголын Хемофилийн Холбоо, 4 ЭХЭМҮТ
Background: Due to the deficit and/or high costs of clotting factor replacement therapy, quality of life and life expectancy of hemophiliacs are lower in low-income countries compared to those of high-income countries. The use of blood products among hemophiliacs without proper management increases the risk of viral hepatitis and HIV infections in Mongolia. The objective of this study was to evaluate medical and social issues of Mongolian patients with hemophilia.
Materials and methods: We studied 46 patients with hemophilia A and B from the Departments of Hematology of two tertiary level hospitals (State Clinical Hospital and National Center for Maternal and Child Health). In those patients HBsAg, anti-HBs, anti-HCV, anti-HIV, anti-HBc markers were detected by ELISA, and viral nucleic acids were detected by PCR. The study was performed from March 19, 2009 to May 16, 2011 at the Department of Molecular Biology and Genetics and Central Research Laboratory of the Health Sciences University of Mongolia.
Results: Totally, 46 hemophiliacs (age: from 0.2 to 70-years-old, m±SD; 17.5±15.5) from 42 families participated in this study. 28 patients were tested for the presence of HIV, HBV and HCV markers. 18(64.2%) patients were positive for anti-HBc+anti-HBs, 5(14%) patients were positive for anti-HBc+HBsAg, and 15(53.5%) patients were positive for anti-HCV marker. HBV nucleic acids were not detected in any of the patients, while HCV RNA was detected in 50% (7/14) of anti-HCV-positive patients. Although 15 patients (33%) reported that they received clotting factors and blood products every month, the amounts of clotting factor taken by those patients were 20 (SD=16.4) times lower than primary prophylactic dose and 58 (SD=46.3) times lower (p<0.001) than standard dose recommended by the World Federation of Hemophilia.
Conclusion: High prevalence of HCV infection and reduced levels of clotting factor intake among Mongolian hemophiliacs demonstrate the urgent need for improving the management of hemophilia care in Mongolia.
