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Abstract
The present work is to study the assessment of the
presence of liver cirrhosis in patients with hemophilia infected
with HCV and/or HBV using noninvasive biomarkers &
fibroscan without liver biopsy.
The current study has been conducted on 25 male
patients with hemophilia A. All patients had not previously
received therapy for hepatitis. Thirteen of them were less
than15 years(52%) and other twelve were more than15
years(48%) with mean age of 16.7+2.6.
All studied patients had HCV and one only had HBV.
Thirteen of them with duration of hepatitis less than12
years(52%) and other twelve were more than12 years(48%)
with mean duration of 14.8+3.4
All patients were subjected to :full history taking,
thorough clinical examination and laboratory investigation
Including; Factor VIII assay for hemophilia if not recorded in
the files , Factor VIII inhibitor assay. Liver function tests:
ALT, , serum albumin.HBs Ag, HBs Ab, HBc AB,HCV
antibodies . Fibro test which includes five serum biochemical
markers (alpha2 - macroglobulin, haptoglobin, GGT, total
bilirubin and apolipoprotein A1) and fibroscan.
Summary and Conclusion
106
All patients were compared as regarded: age, duration
of hepatitis, severity of hemophilia, type of viral hepatitis,
clinical manifestion of hepatic affection, transfusion history,
ALT.
All Patients were compared regarding fibrosis by both
fibrotest and fibroscan.
There was no significant statistical difference between
fibro test and fibroscan at both age group also there was +ve
correlation between age and values of Fibro Test and Fibro
Scan with no statistically significant difference. Also no
significant statistical difference between Fibro Test and Fibro
Scan and duration of hepatitis.
Regarding degree of fibrosis there is statistically high
significant association between Fibro Test and Fibro Scan.
The current study revealed positive correlation
between duration of hepatitis and both fibro test and
fibroscan with no statistical significant difference. Also there
was positive significant correlation between ALT and both
fibro test and fibroscan. with high statistical significant
difference.
There was positive correlation between fibro test and
fibro scan with high statistically significant difference.
Summary and Conclusion
107
from all these results we concluded that fibro test and
fibroscan seems to be a promising and reliable endogenous,
non invasive marker of hepatic fibrosis in pediatric patients
and as first-line non-invasive assessment of liver fibrosis and
particularly useful in HCV-infected haemophilia patients and
should be considered in this population. And FibroScan would
be able to detect cirrhosis in children with chronic liver
diseases of causes not studied before, such as cystic fibrosis
and biliary atresia.