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Chronic hepatitis in hemophilia.

U Hasiba, J A Spero, J H Lewis

    Scandinavian Journal of Haematology. Supplementum
    |January 1, 1977
    PubMed
    Summary

    Hepatitis B infection and liver dysfunction are common in hemophiliacs receiving extensive plasma fraction treatments. Cryoprecipitate treatment shows significantly lower rates of liver abnormalities, suggesting a safer alternative for managing hemophilia.

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    Area of Science:

    • Hepatology
    • Hematology
    • Virology

    Background:

    • Hemophilia treatment involves plasma-derived fractions, posing a risk of hepatitis B exposure.
    • Assessing liver function and hepatitis B markers is crucial in hemophiliacs undergoing treatment.

    Purpose of the Study:

    • To evaluate the relationship between chronic hepatitis B and liver dysfunction in hemophiliacs based on treatment exposure.
    • To compare liver function test (LFT) results and hepatitis B surface antigen (HbsAg) or antibody (anti-Hbs) status across different treatment groups.

    Main Methods:

    • Enzyme tests (SGOT, SGPT) and serological assays (HbsAg, anti-Hbs) were used to assess liver function and hepatitis B status.
    • Hemophiliacs were categorized into three groups based on treatment: large exposure (≥4 commercial lots), small exposure (≤3 lots), and cryoprecipitate only.
    • Liver function tests and presence of hepatitis B markers were analyzed in relation to treatment history and dosage.

    Main Results:

    • Abnormal LFTs were observed in 87% of the large exposure group and 76% in the small exposure group, compared to only 16% in the cryoprecipitate group.
    • Patients receiving ≥100,000 units of fractions exhibited persistent or intermittent LFT abnormalities.
    • Hepatitis B markers (HbsAg or anti-Hbs) were positive in nearly all patients in the large and small exposure groups.

    Conclusions:

    • Significant biochemical evidence of liver disease exists following extensive exposure to commercial factor VIII or IX fractions.
    • While cryoprecipitate shows a lower incidence of liver dysfunction, the current data do not warrant withdrawing effective fraction treatments due to insufficient evidence of mounting liver damage.
    • Physicians should consider the risk of liver disease when initiating extensive plasma fraction therapy for hemophilia.

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