title: Clinical spectrum of hepatitis C-related liver disease and response to treatment with interferon and ribavirin in haemophilia or von Willebrand disease.
abstract: Our aim was to evaluate the severity of liver disease resulting from chronic hepatitis C in haemophilia or von Willebrand disease and the efficacy of 6 months treatment with interferon alpha and ribavirin. Fifty-five liver biopsies were performed in 43 patients without any bleeding complications, as seen with ultrasound immediately after the biopsy and 48 h thereafter. Histological changes were mild, with low scores for both inflammation and fibrosis, in spite of long exposure to blood products (mean 27 years). Two patients had compensated cirrhosis. Thirty-five out of 39 included patients completed study treatment. Hepatitis C virus (HCV)-RNA was negative in 77% (30/39) of patients at the end of treatment, and 36% (14/39) achieved a complete sustained response at follow-up 6 months after treatment. Treatment failure was more frequent in patients with virus genotype 1 compared with non-1 (P = 0.0003). The response rate correlated well with that of non-haemophilic patients. In summary: (1) liver biopsy was safe with our regimen; (2) liver disease in our patients was usually mild and had a slow progress; (3) only HCV genotype 1 predicted treatment failure; (4) our treatment results agreed with those from non-haemophilic patients.
authors.affiliation: Department for Coagulation Disorders, University of Lund, University Hospital, Malmö, Sweden. stefan.lethagen@medforsk.mas.lu.se
authors.forename: S
authors.initials: S
authors.lastname: Lethagen
authors.forename: A
authors.initials: A
authors.lastname: Widell
authors.forename: E
authors.initials: E
authors.lastname: Berntorp
authors.forename: H
authors.initials: H
authors.lastname: Verbaan
authors.forename: S
authors.initials: S
authors.lastname: Lindgren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D004359:Drug Therapy, Combination; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D005838:Genotype; D006467:Hemophilia A / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D006526:Hepatitis C / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome; D014463:Ultrasonography; D014842:von Willebrand Diseases / Q000188:drug therapy / Q000473:pathology / Q000821:virology*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D012254:Ribavirin