Wolfgang Miesbach: Protecting Liver Health in Bleeding Disorders
Wolfgang Miesbach, Head of the Department of Haemostaseology and the Haemophilia Center of Medical Clinic 2 and Professor of Medicine at Frankfurt University Hospital, shared a post on LinkedIn:
“World Hepatitis Day 2025 – Protecting Liver Health in Bleeding Disorders. Despite curative therapies for hepatitis B and C, people with congenital bleeding disorders (PWBD) remain at elevated risk for liver complications—including fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Landmark data show that even after viral eradication, factors such as metabolic dysfunction, obesity, diabetes, and alcohol drive ongoing liver injury.
New International Guidance (EAHAD, EHC, ISTH, WFH) by La Mura et al. provides a unified, evidence-based framework to proactively monitor, prevent, and manage liver complications in PWBD:
- Universal viral hepatitis screening for all PWBD exposed to blood derivatives, including assessment for occult HBV prior to immunosuppression/gene therapy
- Routine metabolic assessment (focus on MASLD and alcohol), as non-viral liver disease now rivals viral hepatitis in this population
- Non-invasive fibrosis stratification using FIB-4 and FibroScan, reducing need for biopsies and identifying patients at risk of progression
- HCC surveillance (liver ultrasound + AFP every 6 months) for those with advanced fibrosis or cirrhosis—even post-cure
- Gene therapy safety: Comprehensive liver evaluation is essential pre- and post-AAV gene therapy; advanced liver disease remains a contraindication.”
Title: The management of liver disease in people with congenital bleeding disorders: guidance from European Association for Haemophilia and Allied Disorders, European Haemophilia Consortium, ISTH, and World Federation of Hemophilia
Authors: Vincenzo La Mura, Massimo Colombo, Graham R. Foster, Paolo Angeli, Wolfgang Miesbach, Robert Klamroth, Glenn F. Pierce, Brian O’Mahony, Ming Y. Lim, Virginia Hernandez-Gea, Michael Makris, Flora Peyvandi
Read the Full Article.
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