Predictive markers of chronic liver disease in hemophilia.

In an attempt to predict progressive liver damage in hemophiliac patients by noninvasive means, we conducted a retrospective analysis of clinical and laboratory data from 44 liver biopsies taken from 35 hemophiliac patients. This showed that serum IgG was normal in patients with chronic persistent hepatitis (CPH) but significantly elevated in those with chronic active hepatitis (CAH) or cirrhosis (CIR) (P less than .001). Relationships were less significant between liver histology and IgM (P less than .01), IgA (P less than .05), and globulin (P less than .05). This was unaffected by human immunodeficiency virus (HIV) antibody status in asymptomatic individuals. Although patients with progressive liver disease were also older than those with CPH (P less than .001), the immunoglobulin abnormalities were independent of this. Neither clinical examination nor liver biochemistry at the time of biopsy were of significant diagnostic value. Our results indicate that in the absence of AIDS an elevated IgG level is a reliable indicator of progressive hemophilic liver disease.