Liver disease in haemophiliacs: an overstated problem?

Successful percutaneous liver biopsy was carried out on 12 multi-transfused haemophiliacs from the Manchester area with persistently abnormal liver function tests. Only one patient showed evidence of chronic active hepatitis with progression to active micronodular cirrhosis although a further four patients showed some evidence of mild chronic active hepatitis. This represents a much lower incidence of severe histological liver damage than many previous reports and implies that liver biopsy in asymptomatic haemophiliacs may not be indicated as a routine procedure, particularly in the absence of proven therapy. Dynamic liver function tests may prove to be a useful indicator of deteriorating liver function in the otherwise asymptomatic haemophiliac.