UKHCDO guidelines on the management of HCV in patients with hereditary bleeding disorders 2011

Wilde, J. T.; Mutimer, David; Dolan, G.; Millar, Carolyn M.; Watson, Heather; Yee, T. T.; Makris, Michael

doi:10.1111/j.1365-2516.2011.02585.x

Cited by 13 publications

(14 citation statements)

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“…The management of these patients has been reviewed recently in the UKHCDO guidelines [10]. Patients coinfected with HIV and HCV have an approximately twofold greater risk of developing cirrhosis, and progress more rapidly to liver failure compared with HCV monoinfected individuals.…”

Section: Hiv/hcv Co-infected Patientsmentioning

confidence: 99%

New approaches to the management of hepatitis C in haemophilia in 2012

Zoulim

Bailly

2012

Haemophilia

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Summary. Hepatitis C virus (HCV) infection is common in patients with Haemophilia. As in other patients, its natural history is characterized by disease progression towards cirrhosis and hepatocellular carcinoma. Many patients with hereditary bleeding disorders infected with HCV are also infected with HIV which is a factor of faster liver disease progression. In the past years, major progress has been made in the management of hepatitis C with the development of non invasive tools to assess liver fibrosis stage, i.e. fibroscan and biomarkers. With these tools, it is now possible to predict with good accuracy the liver disease stage and to take treatment decision. The landscape of antiviral therapy has evolved rapidly, especially for patients infected with HCV genotype 1. Triple therapy with interferon, ribavirin and protease inhibitors has been approved recently, the results of clinical trials showing a clear added benefit in terms of sustained virologic response in naive patients compared to interferon -ribavirin combination therapy. However, results are less promising in cirrhotic patients who failed a previous line of therapy, with a higher rate of side effects and a lower rate of virologic response in patients who qualified as null responders to IFN based therapy. Clinical trials with triple therapy are ongoing in HCV-HIV coinfected patients. Furthermore, new IFN free regimen relying on the combination of direct acting antivirals are currently being evaluated in HCV genotype 1 and non-1 infected patients. These advances provide new hope in the management of chronic hepatitis C, including patients with hereditary bleeding disorders.

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Section: Hiv/hcv Co-infected Patientsmentioning

confidence: 99%

New approaches to the management of hepatitis C in haemophilia in 2012

Zoulim

Bailly

2012

Haemophilia

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“…The availability of many methods of investigation offers the potential to follow patients with liver disease accurately and safely: laboratory, instrumental techniques, clinical history; liver function tests and platelet count should be performed twice a year; prothrombin time and α ‐fetoprotein once a year; transient elastography every 2 yr and ultrasound every 3 yr. Liver biopsy is the gold standard for diagnosis; the rate of clinically significant bleeding when performing liver biopsy can be minimised to 1–2% with adequate clotting factor coverage. The UK Haemophilia Centre Doctors’ Organisation (UKHCDO) has produced a set of guidelines for managing and treating PWH who have hepatitis C infection . A multicentre cohort study of antiviral therapy for 295 patients with haemophilia and hepatitis C infection has been carried out; the authors found that 119 patients achieved a sustained virological response after first treatment and an additional 28 patients were successfully retreated.…”

Section: Liver Complicationsmentioning

confidence: 99%

“…The importance of the need to treat hepatitis C virus infection in this patient group should therefore be emphasised. Guidelines for treatment have been recommended by the UKHCDO .…”

Section: Liver Complicationsmentioning

confidence: 99%

The ageing patient with haemophilia

Canaro

Goranova-Marinova

Berntorp

2015

European J of Haematology

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Older patients with haemophilia (PWH) face many challenges related not only to haemophilia but also to general comorbidities associated with ageing. This article discusses the clinical experience published about the high prevalence of diseases in older PWH. These conditions are managed in the general population by healthcare workers with little training in haemophilia. Haemophilic arthropathy is common in elderly PWH. Prophylaxis starting at an early age in sufficient dose regimens to prevent arthropathy did not occur in patients who are now older than around 40 yr. Many PWH above this age thus have limitations in their activities of daily life. Cardiovascular diseases have become increasingly common in the growing, ageing cohort of PWH. Lifestyle issues such as sexual dysfunction may be exacerbated by the medical issues and psychological problems associated with haemophilia. Hepatitis C virus is a leading problem in PWH. Coinfection with HIV accelerates the progression to end-stage liver disease. Acute and chronic renal failure is more common in adult PWH than in general population. Other comorbidities are reviewed. The evidence is scarce, so it is imperative to report any experience regarding the diagnosis and treatment of these entities, to improve the quality of life of older PWH.

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“…In around 20–30% of cases, HCV infection can progress to cirrhosis, culminating in end‐stage liver disease or hepatocellular carcinoma (HCC) [1]. Liver transplantation is the treatment of choice for patients with end‐stage liver disease as well as for those with small HCC [2]. The outcomes of liver transplantation in general are good with 1‐year survival approaching 90% and 5‐year survival reaching 75% in some centres [3].…”

Section: Viral Infection Of Donors and Their Suitability For Use In Lmentioning

confidence: 99%