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Liver disease in hemophiliacs: etiological and biochemical data on 159 cases from our geographical area
Insights
Hepatitis B virus (HBV) infection is common in hemophiliacs, with infection rates increasing with age and treatment frequency. Liver damage in these patients may stem from causes beyond HBV infection, necessitating further research.
Area of Science:
- Hepatology
- Virology
- Hematology
Background:
- Hemophiliacs are at increased risk for bloodborne infections, including Hepatitis B virus (HBV).
- Assessing the prevalence and impact of HBV infection in this vulnerable population is crucial for patient management.
Purpose of the Study:
- To determine the serological evidence of HBV infection and biochemical evidence of liver disease in hemophiliacs.
- To evaluate the HBV infection rate, risk factors, and the prevalence of anti-delta antibodies.
- To investigate the contribution of HBV to liver dysfunction in hemophiliacs.
Main Methods:
- Screening of 159 hemophiliacs for HBsAg, anti-HBs, and anti-HBc antibodies.
- Biochemical assessment of liver function (AST, gamma-globulin).
- Follow-up evaluation of HBV infection rates and seroconversion over a three-year period.
Main Results:
- 10% of hemophiliacs tested positive for HBsAg, and 67% showed evidence of past or present HBV infection.
- The annual HBV infection rate was 28%, increasing with age and treatment frequency.
- Anti-delta antibodies were found in 28% of HBsAg-positive cases.
- In 61% of patients with liver dysfunction, HBV infection was not the sole cause.
- 80% of patients exhibited elevated AST and/or gamma-globulin levels, more pronounced in HBsAg-positive and anti-delta positive individuals.
Conclusions:
- HBV infection is highly prevalent in hemophiliacs, with significant risk factors identified.
- The etiology of liver disease in hemophiliacs is multifactorial, often involving more than just HBV infection.
- Long-term prognosis of liver disease in hemophiliacs requires further investigation, especially considering co-infections and other contributing factors.
Abstract:
A total of 159 hemophiliacs (149 treated) from our geographical area were screened in 1983 for serological evidence of HBV infection and biochemical evidence of liver disease. All were asymptomatic. HBsAg was detected in 16 cases (10%); anti-HBs and anti-HBc in 106 (67%); 19 (12%) subjects were susceptible to HBV. The HBV infection rate evaluated in 70 patients followed-up from 1980 to 1983 was 28% per year. The cumulative risk of HBV infection as well as the rate of seroconversion to HBV increased with increasing age and with increasing frequency of treatment given during the last 12 months. Anti-delta was detected in the serum of 5 (28%) out of 13 HBsAg-positive cases. Follow-up data showed that in 61% of subjects with liver dysfunction, hepatic damage could not be accounted for by HBV infection. AST and/or gamma-globulin increase was detected in 80% of patients. Abnormalities were more pronounced in HBsAg-positive cases and among them in subjects carrying anti-delta. Further follow-up studies are needed to clarify the long-term prognosis of liver disease in hemophiliacs.