Liver stiffness measurements to assess progression of fibrosis in HCV-infected patients with inherited bleeding disorders

• Published in: Haemophilia : the official journal of the World Federation of Hemophilia Vol. 17; no. 5; pp. e975 - e980
• Main Authors: FRANSEN VAN DE PUTTE, D. E., FISCHER, K., DE KNEGT, R. J., POSTHOUWER, D., VAN ERPECUM, K. J., MAUSER-BUNSCHOTEN, E. P.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.09.2011
• Subjects: Adult; Aged; Blood Coagulation Disorders, Inherited - complications; Disease Progression; Elasticity; Elasticity Imaging Techniques - methods; Female; fibroscan; fibrosis progression; haemophilia; hepatitis C; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - pathology; Humans; inherited bleeding disorders; Liver - pathology; Liver Cirrhosis - pathology; liver stiffness measurement; Male; Middle Aged; Young Adult
• ISSN: 1351-8216; 1365-2516
• DOI: 10.1111/j.1365-2516.2011.02542.x

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.