Viral hepatitis in haemophilia: historical perspective and current management

Br J Haematol. 2021 Oct;195(2):174-185. doi: 10.1111/bjh.17438. Epub 2021 May 6.

Abstract

The introduction of clotting factor concentrates has substantially improved the lives of people with clotting factor deficiencies. Unfortunately, the transmission of blood-borne viral infections through these plasma-derived products led to a huge epidemic of human immunodeficiency virus and viral hepatitis in people with haemophilia (PWH). In a significant proportion of PWH exposed to these viruses, the ensuing decades-long chronic infection resulted in excess morbidity and mortality. Fortunately, developments in the safety of blood products, as well as vaccination and highly effective antiviral treatments have improved the prospects of PWH. The present article reviews the background of the viral hepatitis epidemic in PWH, the natural history of hepatitis B and C infections and their long-term management.

Keywords: HBV; HCV; HIV; haemophilia; hepatitis C.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • Blood Coagulation Factors / therapeutic use
  • Blood-Borne Infections / etiology
  • Blood-Borne Infections / prevention & control*
  • Blood-Borne Infections / transmission
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / epidemiology
  • Disease Management
  • HIV / isolation & purification
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • Hemophilia A / complications
  • Hemophilia A / epidemiology
  • Hemophilia A / therapy*
  • Hepatitis, Viral, Human / complications
  • Hepatitis, Viral, Human / drug therapy
  • Hepatitis, Viral, Human / prevention & control*
  • Hepatitis, Viral, Human / transmission
  • Humans
  • Liver Neoplasms / pathology
  • Liver Transplantation / adverse effects
  • Middle Aged
  • Morbidity / trends
  • Mortality / trends
  • Persistent Infection
  • Vaccination / methods
  • Young Adult

Substances

  • Antiviral Agents
  • Blood Coagulation Factors