Search

Liver function was studied in 139 of 291 haemophiliacs known to a single Regional Haemophilia Centre including patients with classical haemophilia, Christmas disease and von Willebrand's disease. In 57 patients, six-monthly liver function tests over a five year period were also available. Thirty-nine of the 139 patients had had jaundice or hepatitis and 56 had a positive test for HBsAb in the blood although few of these had had an identifiable clinical illness. Fifty-eight haemophiliacs had elevated serum aminotransferases at the time of study, but the five year review revealed only six patients who had had persistently abnormal results, although none had clinically evident liver disease. Liver dysfunction was unrelated to a history of hepatitis, to a positive HBsAb test, or to age, type of haemophilia, factor level or frequency of factor replacement treatment. Abnormalities of liver function in haemophilia appear to be unrelated to past or present hepatitis B infection in most cases and may not be related to any single transmitted infectious agent.

In 1983 304 serum samples, and in 1984 432 serum samples submitted to the Hepatitis Reference Laboratory, Ruchill Hospital, Glasgow were found to be positive for HBsAg by radio-immunoassay. Of these, 37 in 1983 and 50 in 1984 were from persons less than 18 years, while 38 and 46 respectively were from persons greater than 39 years. This increase from 1983 to 1984 was due to more acute infections among males. In males less than 18 years, infections were related to drug abuse, whereas in men greater than 39 years sexual transmission appeared to be the main source. Women greater than 39 years may be at increased risk of infection from other members of the household. A finding of HBsAg in a person greater than 39 years is likely to be from an acute infection as from a carrier.