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.

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doi.org/10.1111/j.1365-2516.2011.02542.x, hdl.handle.net/1765/34294
Erasmus MC: University Medical Center Rotterdam

Fransen van de Putte, D. E., Fischer, K., de Knegt, R., Posthouwer, D., van Erpecum, K., & Mauser-Bunschoten, E. (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