Format

Send to

Choose Destination
See comment in PubMed Commons below
J Hepatol. 2014 Jan;60(1):39-45. doi: 10.1016/j.jhep.2013.08.010. Epub 2013 Aug 23.

Long-term follow-up of hepatitis C infection in a large cohort of patients with inherited bleeding disorders.

Author information

  • 1Van Creveldkliniek, Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: D.E.FransenvandePutte@umcutrecht.nl.
  • 2Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, United Kingdom.
  • 3Van Creveldkliniek, Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
  • 4Katharine Dormandy Haemophilia Centre and Thrombosis Unit, Royal Free London NHS Foundation Trust, London, United Kingdom.
  • 5Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • 6Department of Hepatology, Royal Free London NHS Foundation Trust, London, United Kingdom.
  • 7Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Medical Microbiology and Public Health Research Institute (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands.
  • 8Van Creveldkliniek, Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands.

Abstract

BACKGROUND & AIMS:

Patients with inherited bleeding disorders are an interesting group to study the long-term course of chronic hepatitis C virus (HCV) infection, because of their uniform mode of infection and reliable follow-up. Our aim was to assess the long-term occurrence of adverse liver-related events in these patients.

METHODS:

The occurrence and determinants of end-stage liver disease (ESLD) were assessed using retrospective data of 863 HCV infected patients with inherited bleeding disorders from the Netherlands and the UK.

RESULTS:

Median follow-up since HCV infection was 31 years, while 30% of patients had >35 follow-up years. Nineteen percent of patients spontaneously cleared the virus and 81% developed chronic HCV infection. Of the 700 patients with chronic HCV, 90 (13%) developed ESLD. Hepatocellular carcinoma (HCC) was diagnosed in 3% of patients with chronic HCV, 41% of which occurred in the last six years. Determinants of ESLD development were age at infection (hazard ratio (HR) 1.09 per year increase), HIV co-infection (HR 10.85), history of alcohol abuse (HR 4.34) and successful antiviral treatment (HR 0.14). Of the 487 patients who were still alive at the end of follow-up, 49% did not undergo optimal conventional antiviral treatment.

CONCLUSIONS:

After over 30 years of HCV infection, ESLD occurred in a significant proportion of patients with inherited bleeding disorders. HCC appears to be an increasing problem. There is a significant potential for both conventional and new antiviral treatment regimens to try and limit ESLD occurrence in the future.

Copyright © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

KEYWORDS:

AIDS; CI; ESLD; End-stage liver disease; HAART; HCC; HCV; HIV; HR; Hemophilia; Hepatitis C; Hepatocellular carcinoma; IFN; Inherited bleeding disorders; LSM; Long-term follow-up; PegIFN; SVR; UK; United Kingdom; acquired immunodeficiency syndrome; confidence interval; end-stage liver disease; hazard ratio; hepatitis C virus; hepatocellular carcinoma; highly active antiretroviral treatment; human immunodeficiency virus; interferon; liver stiffness measurement; pegylated interferon; sustained virological response

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk