Open AccessEvaluation of nonneutralizing antibodies against factor VIII in severe haemophilia A patients from India
Author(s) -
Sachin David,
Nitty Skariah Mathews,
Gyaninder Pal Singh,
Anu Korula,
Fouzia N. Aboobacker,
Aby Abraham,
Biju George,
Alok Srivastava,
Vikram Mathews,
Sukesh C. Nair
Publication year - 2019
Publication title -
blood coagulation and fibrinolysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.376
H-Index - 71
eISSN - 1473-5733
pISSN - 0957-5235
DOI - 10.1097/mbc.0000000000000843
Subject(s) - haemophilia , medicine , haemophilia a , antibody , population , cohort , immunology , pediatrics , gastroenterology , environmental health
: Haemophilia A is treated by replacement therapy with factor VIII (FVIII) concentrate. This strategy of treatment is ineffective in some patients due to the development of neutralizing antibodies (NNAs) against FVIII. The inhibitors have been identified to act against the functional domains of FVIII. The presence of NNAs against FVIII has also been identified. There is limited data on the prevalence and significance of NNA in haemophilia. To identify the presence of NNA in severe haemophilia A in our population, patients who were recruited from community-based camps were evaluated for FVIII activity. The patient's samples were further analysed for inhibitor activity with Nijmegen-Bethesda Assay and for NNAs using an in-house ELISA. 312 severe haemophilia patients were analysed for inhibitors and NNA. In-house ELISA picked up antibodies in 56 patients (17.9%). Of these 42 (13.7%) had inhibitory antibodies and in 14 patients (4.5%) there was no evidence of FVIII inhibitory activity. A substantial number of patients with severe haemophilia A have NNA. Continuous long-term follow-up is required in this cohort to evaluate the significance of this observation.