Hepatitis C contributes to liver disease in children and adolescents with hemophilia.

Abstract

Non-A non-B (NANB) hepatitis plays a major role in liver disease in hemophiliacs. HCV is known to be the predominant cause for blood-borne NANB hepatitis. A cross-sectional study for anti-HCV and anti-HIV-1 antibodies in sera, presence of HBsAg in sera and liver function tests was conducted in 116 male patients with hemophilia (mean age: 14.6 years) in order to study the impact of hepatitis C as well as the significance of concurrent hepatitis B and HIV infection on the liver disease in hemophilic children and adolescents. 56.9% of the patients tested seropositive for anti-HCV; the mean age of the anti-HCV positive group was higher than that of the anti-HCV seronegative group (15.9 versus 11.9 years). Seropositivity to anti-HCV was more often associated with abnormal liver function than it was found in the seronegative group (37.9% versus 17%). Eight of nine patients positive for anti-HCV and HBsAg showed abnormal liver function tests. 68.9% of the anti-HIV-1 positive patients were also anti-HCV positive compared to 44.8% of the anti-HIV-1 negative patients. The liver function tests revealed an abnormal result in 47% of the anti-HIV-1 positive patients compared to 20.7% in the anti-HIV-1 negative group. In conclusion, a high seroprevalence for anti-HCV is detected in young patients with hemophilia which is associated with liver disease in a considerable number of patients when assessed by liver function tests. The coinfection of HCV and HBV seems to increase the risk of liver as also does concurrent HIV-1 infection, which is assumed to contribute to liver disease in a yet unexplained way.