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Blood, 1 May 2007, Vol. 109, No. 9, pp. 3667-3671. Prepublished online as a Blood First Edition Paper on January 9, 2007; DOI 10.1182/blood-2006-08-038349. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-08-038349v1 109/9/3667    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Posthouwer, D. Articles by Mauser-Bunschoten, E. P. Search for Related Content PubMed PubMed Citation Articles by Posthouwer, D. Articles by Mauser-Bunschoten, E. P. Related Collections Hemostasis, Thrombosis, and Vascular Biology Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Progression to end-stage liver disease in patients with inherited bleeding disorders and hepatitis C: an international, multicenter cohort study Dirk Posthouwer1, Michael Makris2, Thynn T. Yee3, Kathelijn Fischer1,4, Joost J. van Veen2, Anja Griffioen3, Karel J. van Erpecum5, and Eveline P. Mauser-Bunschoten1 1 Van Creveldkliniek, University Medical Center Utrecht, The Netherlands; 2 Sheffield Haemophilia and Thrombosis Centre, Sheffield, United Kingdom; 3 Haemophilia Centre and Haemostasis Unit, Royal Free Hospital, London, United Kingdom; 4 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands; 5 Department of Hepatology and Gastroenterology, University Medical Center Utrecht, The Netherlands Prior to 1990, many patients with inherited bleeding disorders were infected with hepatitis C virus (HCV). This study assessed the risk of end-stage liver disease (ESLD) in patients with hemophilia with chronic hepatitis C. Patients were infected between 1961 and 1990 and were followed up to August 2005. Of 847 anti-HCV+ patients, 160 (19%) spontaneously cleared HCV and 687 (81%) developed chronic hepatitis C. Coinfection with HIV was present in 210 patients. After 35 years of infection the cumulative incidence of ESLD was 11.5% (95% CI, 8.2%-14.8%) in HIV– patients and 35.1% (95% CI, 29.2%-41.0%; P < .001) in patients coinfected with HIV. Independent risk factors of ESLD were HIV coinfection (hazard ratio 13.8; 95% CI, 7.5-25.3), older age at infection (hazard ratio 2.3 per 10 years; 95% CI, 2.0-2.8), alcohol abuse (hazard ratio 4.9; 95% CI, 2.5-9.6), and presence of HCV genotype 1 (hazard ratio 2.2; 95% CI, 1.1-4.2). With longer duration of HCV infection, the risk of developing ESLD is emerging in patients with inherited bleeding disorders. Risk factors for rapid progression to ESLD are alcohol abuse, coinfection with HIV, older age at infection, and presence of HCV genotype 1. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. Franchini, C. Mengoli, D. Veneri, R. Mazzi, G. Lippi, and M. Cruciani Treatment of chronic hepatitis C in haemophilic patients with interferon and ribavirin: a meta-analysis J. Antimicrob. Chemother., June 1, 2008; 61(6): 1191 - 1200. [Abstract] [Full Text] [PDF] End-Stage Liver Disease Due to HCV Infection in Hemophiliacs Journal Watch Oncology and Hematology, May 25, 2007; 2007(525): 2 - 2. [Full Text]

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