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Nonprogressive course of non-A, non-B chronic hepatitis in multitransfused hemophiliacs
Insights
This study followed eleven hemophiliacs with chronic liver disease. Hemophiliacs without viral markers showed nonprogressive liver disease, indicating a favorable prognosis.
Area of Science:
- Hepatology
- Hematology
- Virology
Background:
- Chronic liver disease is a concern in hemophilia patients.
- Hepatitis B and delta viruses are potential contributors to liver disease in this population.
Purpose of the Study:
- To prospectively evaluate the progression of chronic liver disease in hemophiliacs.
- To investigate the role of viral markers in liver disease progression among hemophiliacs.
Main Methods:
- Prospective study of 11 hemophiliacs over 6 years.
- Regular liver function tests and liver biopsies at 3-year intervals.
- Analysis of serum and intrahepatic markers for hepatitis B and delta viruses.
Main Results:
- Four patients maintained chronic persistent hepatitis.
- Two patients progressed to chronic lobular hepatitis.
- Four patients with chronic active hepatitis showed spontaneous improvement.
- One patient with active cirrhosis died from liver failure.
- Nonprogressive liver disease was observed in patients lacking intrahepatic viral markers.
Conclusions:
- Chronic liver disease in hemophiliacs without intrahepatic viral markers appears nonprogressive.
- Spontaneous improvement in chronic active hepatitis can occur.
- Liver disease progression and outcomes vary among hemophiliacs.
Abstract:
Eleven hemophiliacs with chronic liver disease were studied prospectively for 6 yr, with liver function tests and liver biopsies carried out at intervals of 3 yr. The second series of biopsies, compared with the first series, showed continuation of chronic persistent hepatitis in four patients, change to chronic lobular hepatitis in two, and spontaneous improvement of the disease in the four cases who had had chronic active hepatitis characterized by moderate piecemeal necrosis. One patient with active cirrhosis died of liver failure during the follow-up period. Study of the serum and intrahepatic markers for hepatitis B and delta viruses suggests that chronic liver disease is nonprogressive in hemophiliacs who have no intrahepatic viral marker.