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Long-term liver-related morbidity and mortality related to chronic hepatitis C virus infection in Swedish patients with inherited bleeding disorders
Coagulation Unit, Department of Medicine Solna, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.
Department of Infectious Diseases, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden.
Karolinska Institutet at Karolinska Hospital, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Department of Infectious Diseases.ORCID iD: 0000-0001-7248-0910
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2016 (English)In: Haemophilia, ISSN 1351-8216, E-ISSN 1365-2516, Vol. 22, no 6, e494-e501 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: Hepatitis C virus (HCV) infection is common in patients with inherited bleeding disorders treated with clotting factor concentrates prior to the introduction of viral inactivation of these products. The long-term consequences of hepatitis C infection in Swedish patients are not fully understood.

Aim: To examine the impact of HCV infection on liver-related morbidity and mortality in Swedish patients with inherited bleeding disorders.

Methods: We retrospectively collected data on 183 patients with inherited bleeding disorders infected with HCV who attended the Coagulation Unit at Karolinska University Hospital, Sweden. Data regarding end-stage liver disease (ESLD), defined as presence of ascites, encephalopathy, variceal bleeding, hepatocellular carcinoma or liver-related death, were collected from the patient records and the national registers.

Results: The median follow-up time was 35.9 years (IQR 29.0-41.2). A total of 41% had achieved sustained virological response (SVR) after treatment. In total, 14.2% developed ESLD at the median age of 52.6 years (IQR 46.5-64.7). Nineteen (35.8%) of all deaths were due to liver-related causes. Co-infection with human immunodeficiency virus (HIV), older age at time of infection and severe form of bleeding disorder was associated with higher risk of developing ESLD, while SVR was a strong protective factor.

Conclusions: This study demonstrated that liver-related morbidity and mortality was significant in patients with bleeding disorders and HCV infection in Sweden. Patients with HCV-infection should be candidates for treatment with the new highly effective antiviral drugs, since SVR proved to be a strong protective factor.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2016. Vol. 22, no 6, e494-e501 p.
Keyword [sv]
Haemophilia, hepatitis C, hepatocellular carcinoma, liver complications, liver-related death
National Category
Infectious Medicine Hematology
URN: urn:nbn:se:oru:diva-52877DOI: 10.1111/hae.13020ISI: 000388493000001PubMedID: 27704656ScopusID: 2-s2.0-84994908270OAI: oai:DiVA.org:oru-52877DiVA: diva2:1033903
Available from: 2016-10-10 Created: 2016-10-10 Last updated: 2016-12-19Bibliographically approved

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