A combined management protocol for patients with coagulation disorders infected with hepatitis C virus

M M Ahmed, D J Mutimer, E Elias, J Linin, M Garrido, S Hubscher, L Jarvis, P Simmonds, J T Wilde

Research output: Contribution to journalArticlepeer-review

Abstract

The case notes of 394 adults with bleeding disorders registered at our centre together with those of the 72 patients who had died since 1971 were reviewed. 36/72 deceased patients had evidence of HCV infection. Liver decompensation was present at time of death in six. 274 (70%) of the currently registered patients had received factor concentrate or cryoprecipitate and 174 of these were screened for HCV infection. 76% of tested patients were RIBA positive. 87% of RIBA-positive patients were RT-PCR positive. 50 RIBA-positive patients, including nine who were HIV infected, have undergone percutaneous liver biopsy following appropriate factor infusion with no complication. The biopsy was assessed using a Histological Activity Index (HAI) ranging from 0 to 13. Patients with HAI > or = 6 were offered treatment with interferon. Patients with HAI <6 were followed up with a view to re-biopsy in 2-3 years to assess progression. The median HAI was 4.5 (range 0-10) with HAI > or = 6 in 13 cases (27%). HAI was not correlated with duration of infection. haemophilia severity. RT-PCR status. HIV status or HCV genotype. Liver biopsy, a safe procedure in our hands, is an important investigation in HCV-infected patients to assess suitability for interferon therapy.
Original languageEnglish
Pages (from-to)383-8
Number of pages6
JournalBritish journal of haematology
Volume95
Issue number2
Publication statusPublished - Nov 1996

Keywords

  • Adult
  • Biopsy, Needle
  • Blood Coagulation Disorders
  • Blood Component Transfusion
  • Clinical Protocols
  • Female
  • Hepatitis C
  • Humans
  • Male
  • Retrospective Studies
  • Viral Hepatitis Vaccines

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