Viral Serology (Hepatitis B Virus, Cytomegalovirus, Epstein‐Barr Virus) and Abnormal Liver Function Tests in Transfused Patients with Hereditary Hemorrhagic Diseases

Posttransfusion hepatitis and asymptomatic liver disease remain serious and unresolved problems in transfused patients with hereditary hemorrhagic diseases. We studied the occurrence of antibody and antigen to hepatitis B virus (anti‐Hbs and HBsAg) as well as antibody to cytomegalovirus (anti‐CMV) and Epstein‐Barr virus (anti‐EBV) in this population and correlated this with liver function tests. The study population was divided into two groups: Group I, consisting of 35 patients (moderate to mild disease) requiring less than 12 transfusions per year and Group II, consisting of 38 patients (severe disease) requiring more than 12 transfusions per year. Frequency of transfusion correlated with detectable anti‐HBs and anti‐CMV (48.6% and 25.7% in Group I, 94.7% and 47.4% in Group II). Three patients, all in Group I, were HBsAg positive while none in Group II had demonstrable antigen. Anti‐EBV occurred with similar frequency in both groups. The abnormal liver funtion tests present in 62.9 per cent of Group I and 89.5 per cent of Group II correlated poorly with the presence of anti‐HBs, anti‐CMV and anti‐EBV. Splenomegaly was not detected in any of the 73 patients. HBV and CMV appear to be transmissible by transfusion, and other viruses such as non‐A, non‐B may account for this liver dysfunction.