Safety and potential usefulness of liver biopsy in HIV-seropositive haemophiliacs employing a transjugular venous approach.

Chronic liver disease has affected a majority of haemophiliacs exposed to factor VIII and factor IX concentrates before effective viral attenuation techniques were introduced. Progressive hepatitis and liver failure have increasingly become causes of morbidity, especially in haemophilia patients also seropositive for HIV. Encouraging reports of recombinant alpha interferon to reverse the histological, laboratory and clinical deterioration of chronic active hepatitis justifies obtaining liver biopsies to assess the severity of liver damage; however, the percutaneous method carries a significant risk of bleeding. Therefore, we employed a transjugular venous approach for liver biopsies in six HCV-, HBSAb- and HIV-seropositive adults with severe haemophilia A (n = 5) or B (n = 1) with persistent liver function abnormalities. Adequacy of the specimens and lack of haemorrhagic complications leads us to conclude that this procedure appears to be safe and effective in individuals with severe haemophilia or other congenital or acquired coagulopathies.