title: Liver stiffness measurements to assess progression of fibrosis in HCV-infected patients with inherited bleeding disorders.
abstract: Hepatitis C is a major co-morbidity in patients with inherited bleeding disorders, leading to progressive liver fibrosis and eventually cirrhosis. Liver stiffness measurement (LSM) is a non-invasive way of assessing the extent of liver fibrosis. This article describes our experience with serial LSM to assess prospectively progression of fibrosis in a cohort of patients with inherited bleeding disorders and chronic hepatitis C. A total of 84 patients underwent serial LSMs, with a median interval of 3.7 years. The change in LSM results over time was assessed. Overall, there was no significant difference between the median results of LSM 1 and LSM 2. The median result of LSM 2 was low (6.6 kPa), after a median duration of infection of 37 years. On the individual level, deterioration of LSM results of more than 2 kPa was seen in 13 patients (16%), 44 patients (52%) remained stable and 27 patients (32%) showed improvement of LSM results of more than 2 kPa. These results are comparable with those of paired liver biopsy studies. LSM appears to be a good alternative for liver biopsies in patients with hepatitis C and inherited bleeding disorders, although the interpretation of the unexpected improvement we found in some of our patients is not straightforward. LSMs will be repeated in our patient population in a few years to be able to better assess the value of serial LSM.
authors.affiliation: Van Creveldkliniek, Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands. d.e.fransenvandeputte@umcutrecht.nl
authors.forename: D E
authors.initials: DE
authors.lastname: Fransen van de Putte
authors.forename: K
authors.initials: K
authors.lastname: Fischer
authors.forename: R J
authors.initials: RJ
authors.lastname: de Knegt
authors.forename: D
authors.initials: D
authors.lastname: Posthouwer
authors.forename: K J
authors.initials: KJ
authors.lastname: van Erpecum
authors.forename: E P
authors.initials: EP
authors.lastname: Mauser-Bunschoten
mesh_terms: D000328:Adult; D000368:Aged; D025861:Blood Coagulation Disorders, Inherited / Q000150:complications*; D018450:Disease Progression; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult