ORIGINAL ARTICLE Hepatitis

The changing face of hepatitis in boys with haemophilia associated with increased prevalence of obesity

  1. S. REVEL-VILK1,†,
  2. P. KOMVILAISAK1,
  3. V. BLANCHETTE1,
  4. A. M. STAIN1,
  5. G. FLOROS2,
  6. A. COCHRANE1,
  7. C. BLANCHETTE1,
  8. M. HANG1,
  9. E. A. ROBERTS3,
  10. S. C. LING3,4

Article first published online: 21 MAR 2011

DOI: 10.1111/j.1365-2516.2010.02477.x

Issue

Haemophilia

Haemophilia

Volume 17, Issue 4, pages 689–694, July 2011

Additional Information

How to Cite

REVEL-VILK, S., KOMVILAISAK, P., BLANCHETTE, V., STAIN, A. M., FLOROS, G., COCHRANE, A., BLANCHETTE, C., HANG, M., ROBERTS, E. A. and LING, S. C. (2011), The changing face of hepatitis in boys with haemophilia associated with increased prevalence of obesity. Haemophilia, 17: 689–694. doi: 10.1111/j.1365-2516.2010.02477.x

Author Information

  1. 1

    Division of Hematology/Oncology

  2. 2

    Department of Nursing

  3. 3

    Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada

  4. 4

    Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada

  1. †

    Present address: The Pediatric Hematology/Oncology Department, Hadassah Hebrew-University Hospital, Jerusalem, Israel, and of P.K. is the Pediatric Department, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.

*Dr. Victor S Blanchette, Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. Tel.: +1 416-813-5852; fax: +1 416-813-5327; e-mail: victor.blanchette@sickkids.ca

Publication History

  1. Issue published online: 21 JUN 2011
  2. Article first published online: 21 MAR 2011
  3. Accepted after revision 19 November 2010

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Keywords:

  • haemophilia;
  • hepatitis;
  • non-alcoholic fatty liver disease;
  • obesity;
  • overweight

Summary.  Hepatitis in children with haemophilia was historically most often associated with transfusion-transmitted infections. However, with the use of recombinant clotting factor concentrates, acquisition of such infections has now become rare. We studied the profile of hepatitis in North-American children with haemophilia in the modern era of safe blood products and excess childhood obesity. A total of 173 boys (<18 years) registered in the Pediatric Comprehensive Care Haemophilia Program were included in this retrospective study. Hospital records were reviewed for baseline data, serial height and weight measurements and serial alanine aminotransferase (ALT) levels. A body mass index (BMI) ranking was available for 170 boys, of whom 25 (14.7%, 95% CI 9.7–20.9%) were obese. The rate of obesity was higher in severe haemophilic boys. Compared with the general childhood population, the rate of obesity trended towards being higher in young haemophilic boys (2–5 years), but was similar in other age groups. A persistently high ALT (≥80 U L−1) was documented in 5 boys and was associated with obesity. Three boys had clinical and imaging studies compatible with non-alcoholic fatty liver disease (NAFLD). Overweight and obesity are common among haemophilic boys, especially those who are younger and with severe disease. In this large group of haemophilic boys, chronic viral hepatitis was rare and NAFLD was a more common cause of liver disease. Overweight and obese haemophilic boys should be evaluated for NAFLD and interventional programmes should be designed to reduce the potential complications associated with obesity.

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