Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
Liver biopsy in Irish hepatitis C-infected patients with inherited bleeding disorders.
Br J Haematol. 2000 May;109(2):354-9. Unique Identifier : AIDSLINE MED/20308115 McMahon C; Pilkington R; Shea EO; Kelleher D; Smith OP; National Centre for Inherited Bleeding Disorders and Department; of Gastroenterology, St James's Hospital, Dublin 8, Ireland.
Abstract:
The majority of patients receiving plasma-derived clotting factor concentrates between 1970s and the mid-1980s are now hepatitis C positive. The progression of hepatitis C is extremely variable and there is frequently a poor correlation among liver biochemistry, viral load and the stage of liver disease. Liver biopsy remains the only definitive way of staging fibrosis and grading necroinflammatory activity. Concerns have been expressed about the safety of the procedure; however, with modern regimes for the correction of coagulopathy in patients with inherited bleeding disorders, normal haemostasis may be maintained during the peribiopsy period. We performed 21 liver biopsies between 1984 and 1997 on patients with factor VIII (FVIII) or IX (FIX) deficiency and von Willebrand's Disease (VWD). Four had concomitant human immunodeficiency virus (HIV) infection, five were thrombocytopenic and one had a prolonged prothrombin time (PT). Haemostasis was achieved using an intermittent bolus of factor concentrate or continuous infusion regimens. One patient with VWD received Desmopressin (DDAVP). There were no bleeding episodes associated with biopsy. We suggest that liver biopsy is a safe procedure in patients with inherited bleeding disorders when the coagulopathy is fully corrected. It is the only definitive method of staging the extent of fibrosis associated with hepatitis C infection, and it is this that defines prognosis.
Keywords: JOURNAL ARTICLE REVIEW REVIEW, MULTICASE von Willebrand Disease/PATHOLOGY/VIROLOGY Adult Biopsy Female Fibrosis Hemophilia A/*PATHOLOGY/*VIROLOGY Hemophilia B/PATHOLOGY/VIROLOGY Hepatitis C/*PATHOLOGY Human Ireland Length of Stay Liver/*PATHOLOGY Male Middle Age Morbidity
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Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
