Dietje Elisabeth Fransen van de Putte1, Michael Makris2, Kathelijn Fischer3, Thynn Thynn Yee4, Lisa Kirk2, Karel Johannes van Erpecum5, David Patch6, Dirk Posthouwer7, Eveline Pauline Mauser-Bunschoten8. 1. Van Creveldkliniek, Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: D.E.FransenvandePutte@umcutrecht.nl. 2. Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, United Kingdom. 3. Van 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. 4. Katharine Dormandy Haemophilia Centre and Thrombosis Unit, Royal Free London NHS Foundation Trust, London, United Kingdom. 5. Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands. 6. Department of Hepatology, Royal Free London NHS Foundation Trust, London, United Kingdom. 7. Department 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. 8. Van 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.
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 infectedpatients 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.
Authors: Tiago Pereira Guedes; Mónica Garrido; Ricardo Kuttner Magalhães; Teresa Moreira; Marta Rocha; Luís Maia; José Manuel Ferreira; Sara Morais; Isabel Pedroto Journal: GE Port J Gastroenterol Date: 2020-09-29
Authors: Cas J Isfordink; Sylvia M Brakenhoff; Marleen van Dijk; Marc van der Valk; Rob J de Knegt; Joop E Arends; Joost Ph Drenth Journal: BMJ Open Gastroenterol Date: 2020-04-12
Authors: Christian Qvigstad; Robert Campbell Tait; Stephan Rauchensteiner; Erik Berntorp; Philippe de Moerloose; Roger E Schutgens; Pål Andre Holme Journal: Medicine (Baltimore) Date: 2018-09 Impact factor: 1.889