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 3.7years. 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 (6.6kPa), after a median duration of infection of 37years. On the individual level, deterioration of LSM results of more than 2kPa was seen in 13 patients (16%), 44 patients (52%) remained stable and 27 patients (32%) showed improvement of LSM results of more than 2kPa. 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.

Additional Metadata
Keywords Fibroscan, Fibrosis progression, Haemophilia, Hepatitis C, Inherited bleeding disorders, Liver stiffness measurement
Persistent URL dx.doi.org/10.1111/j.1365-2516.2011.02542.x, hdl.handle.net/1765/34294
Citation
Fransen van de Putte, D.E, Fischer, K, de Knegt, R.J, Posthouwer, D, van Erpecum, K.J, & Mauser-Bunschoten, E.P. (2011). Liver stiffness measurements to assess progression of fibrosis in HCV-infected patients with inherited bleeding disorders. Haemophilia, 17(5). doi:10.1111/j.1365-2516.2011.02542.x