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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 (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 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 Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted August 1, 2006 Accepted December 22, 2006 Progression to end-stage liver disease in patients with inherited bleeding disorders and hepatitis C: an international, multicenter cohort-study Dirk Posthouwer, Michael Makris, Thynn T Yee, Kathelijn Fischer, Joost J van Veen, Anja Griffioen, Karel J van Erpecum, and Eveline P Mauser-Bunschoten* Van Creveldkliniek, University Medical Center, Utrecht, Netherlands Sheffield Haemophilia and Thrombosis Centre, Sheffield, United Kingdom Haemophilia Centre and Haemostasis Unit, Royal Free Hospital, London, United Kingdom Julius Center of Health Sciences and Primary Care, University Medical Center, Utrecht, Netherlands Department of Hepatology and Gastroenterology, University Medical Center, Utrecht, Netherlands * Corresponding author; email: e.mauserbunschoten{at}umcutrecht.nl. Prior to 1990, many patients with inherited bleeding disorders were infected with hepatitis C virus (HCV). The aim of this study was to assess the risk of end stage liver disease (ESLD) in hemophilia patients with chronic hepatitis C. Patients were infected between 1961 and 1990, and were followed up to August 2005. Of 847 anti-HCV positive 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% C.I. 8.2-14.8%) in HIV negative patients and 35.1% (95% C.I. 29.2-41.0, p<0.001) in HIV co-infected patients. Independent risk factors of ESLD were: HIV co-infection (hazard ratio 13.8 [95% C.I. 7.5-25.3], older age at infection (hazard ratio 2.3 per 10 years [95% C.I. 2.0-2.8]), alcohol abuse (hazard ratio 4.9 [95% C.I. 2.5-9.6]), and presence of genotype 1 (hazard ratio 2.2 [95% C.I. 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, co-infection with HIV, older age at infection, and presence of 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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