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

D.E. Fransen Van de Putte, M. Makris, K. Fischer, T.T. Yee, L. Kirk, K.J. van Erpecum, D. Patch, D. Posthouwer, E.P. Mauser-Bunschoten

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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.
Original languageEnglish
Pages (from-to)39-45
JournalJournal of Hepatology
Volume60
Issue number1
DOIs
Publication statusPublished - 1 Jan 2014

Cite this

Fransen Van de Putte, D. E., Makris, M., Fischer, K., Yee, T. T., Kirk, L., van Erpecum, K. J., Patch, D., Posthouwer, D., & Mauser-Bunschoten, E. P. (2014). Long-term follow-up of hepatitis C infection in a large cohort of patients with inherited bleeding disorders. Journal of Hepatology, 60(1), 39-45. https://doi.org/10.1016/j.jhep.2013.08.010