Makris M, Preston F E
Department of Haematology, Royal Hallamshire Hospital, Sheffield, UK.
Blood Rev. 1993 Dec;7(4):243-50. doi: 10.1016/0268-960x(93)90011-r.
Chronic hepatitis affects almost all haemophiliacs treated with non-virally inactivated clotting factor concentrates. The virus responsible is hepatitis C (HCV) and most patients have non-neutralising antibodies with circulating virus. Although the majority also have evidence of past infection with hepatitis B, less than 5% are chronic carriers of HBsAg. Chronic hepatitis C can be associated with severe and progressive liver disease but the development of complications is slow. Treatment with recombinant interferon alpha given subcutaneously normalises the liver function in 50% of patients, but 50% of responders relapse on stopping treatment. Liver transplantation is successful in patients with advanced liver disease and it offers the added advantage of phenotypic cure of the haemophilic state.
慢性肝炎几乎影响所有接受非病毒灭活凝血因子浓缩物治疗的血友病患者。致病病毒为丙型肝炎病毒（HCV），大多数患者有针对循环病毒的非中和抗体。虽然大多数患者也有既往感染乙型肝炎的证据，但不到5%是HBsAg慢性携带者。慢性丙型肝炎可伴有严重且进展性的肝脏疾病，但并发症的发展较为缓慢。皮下注射重组干扰素α治疗可使50%的患者肝功能恢复正常，但50%的缓解者在停药后复发。肝移植对晚期肝病患者是成功的，并且它还具有使血友病状态表型治愈的额外优势。
