Liver dysfunction in Pennsylvania's multitransfused hemophiliacs.

Area of Science:

• Hepatology
• Hematology
• Virology

Background:

• Hemophiliacs are at increased risk of blood-borne infections due to frequent exposure to blood products.
• Hepatitis B virus (HBV) is a significant concern in this population.
• Monitoring liver enzymes and hepatitis B markers is crucial for patient management.

Purpose of the Study:

• To assess the incidence of hepatitis B infection and persistently abnormal transaminase levels in hemophiliacs.
• To compare the risks associated with different types of blood product treatments.

Main Methods:

• Serial determination of transaminase values (ALT, AST) and hepatitis B markers in 558 hemophiliacs.
• Comparison of outcomes between patients treated with factor concentrates versus fresh frozen plasma (FFP) or cryoprecipitate.
• Analysis of data considering the amount of blood products received.

Main Results:

• 6% of patients had persistent hepatitis B surface antigen (HBsAg).
• Antibody to hepatitis B surface antigen (anti-HBs) was higher in concentrate recipients (90%) vs. FFP/cryoprecipitate recipients (49%).
• Persistently abnormal transaminases were significantly more frequent in concentrate recipients (31%) compared to FFP/cryoprecipitate recipients (2%).

Conclusions:

• Treatment with factor concentrates is associated with a higher risk of hepatitis B infection and persistently abnormal transaminase levels in hemophiliacs.
• Fresh frozen plasma and cryoprecipitate appear to be safer alternatives regarding hepatitis B transmission and liver enzyme abnormalities.
• Further strategies are needed to mitigate hepatitis B risks in hemophiliac patients.