HEPATITIS-C CONTRIBUTES TO LIVER-DISEASE IN CHILDREN AND ADOLESCENTS WITH HEMOPHILIA

Non-A non-B (NANB) hepatitis plays a major role in liver disease in he mophiliacs. HCV is known to be the predominant cause for blood-borne N ANB hepatitis. A crossectional study for anti-HCV and anti-HIV-1 antib odies 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 significanc e of concurrent hepatitis B and HIV infection on the liver disease in hemophilic children and adolescents. 56.9% of the patients tested sero positive 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 abn ormal 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-HI V-1 negative patients. The liver function tests revealed an abnormal r esult in 47% of the anti-HIV-l positive patients compared to 20.7% in the anti-HIV-l negative group. In conclusion, a high seroprevalence fo r anti-HCV is detected in young patients with hemophilia which is asso ciated with liver disease in a considerable number of patients when as sessed by liver function tests. The coinfection of HCV and HBV seems t o increase the risk of liver as also does concurrent HIV-1 infection, which is assumed to contribute to liver disease in a yet unexplained w ay.