P-25 SLOWER FIBROSIS PROGRESSION IN HEPATITIS C HEMOPHILIAC PATIENTS?

Introduction

The improvement in the treatment of hemophilia from the 90′s, as well as the advent of interferon-free therapy against HCV enabled a better evolution of these special group of patients. However, the impact of hemophilia on the progression of liver fibrosis is still not completely understood.

Objectives

To evaluate the progression of liver fibrosis in hemophiliac patients with HCV using non-invasive methods after ten years of follow-up.

Casuistic and Method

Retrospective cohort study of hemophiliac patients with HCV evaluated in 2007 and reassessed 10 years later (2017/2018). Hepatic fibrosis was indirectly evaluated by APRI and transient hepatic elastography by Fibroscan ® - EHT).

Results

Sixty-six hemophiliac patients were evaluated in 2007 (all men, median age 31.5 years, 87.9% hemophilia A). Forty-two patients could be reevaluated in 2017/2018. Thirty-three patients were treated with 90.9% SVR; thus, after 10 years, 30 patients were non-viremic and 12 were viremic (3 without SVR and 9 untreated). APRI values were low in both periods but showed a significant reduction in treated patients (0.36 vs 0.20, p <0.001), remaining stable in non-treated (0,61 vs 0,51, p=NS). Fibrosis by EHT was assessed only in 2017/2018 and also showed results compatible with low stages of fibrosis in treated and even in non-treated patients (4.75 and 5.25 kPa, respectively).

Conclusions

After ten years of follow-up the results suggest a slower progression and a more benign evolution of hepatic fibrosis among hemophiliacs. Antiviral therapy against HCV showed an elevated response rate, similar to the general population.