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.

Interferon treatment of chronic active hepatitis C during therapy of acute lymphoblastic leukemia

“…Two large studies found similar frequencies of 0.05 and 0.1% of antibody to HCV among general adolescent populations in the United States [12,13]. Individuals who receive blood products, including those with malignancies [14,15], hemophilia [16,17], sickle cell disease [18], and thalassemia [19,20] have a higher incidence of antibody to HCV compared with the general population. The impact of HCV infection on the tolerance of simultaneous therapy and the natural history of these diseases is only beginning to be defined.…”

Hepatitis C infection in children: A Melbourne perspective

“…Among haemophiliac patients (mean age 14.6 years), 9.5% were co‐infected with HBV and HCV, and 34.4% with HIV‐1 and HCV. 19 Adult carriers of both HBV and HCV were more frequently cirrhotic than those infected with HCV alone. 20 There is also suggestive evidence that HCV/HBV co‐infection act synergistically in causing hepatocellular carcinoma (HCC).…”