Summary:
Aim of this study was to evaluate the natural history of HCV infection in a
cohort of Greek haemophilia patients and investigate the impact of HIV
infection in HCV progression.
A total of 324 haemophilia patients with CHC and known seroconversion dates
were followed up prospectively, among them 160 (49,4%) coinfected with HIV. The
cumulative incidence of ESLD and death without ESLD was estimated using
competing risks methodology. The estimated cumulative incidence (95% CI) of
ESLD at 30 years was 12%. (4,2%,15,8%) In total, 34 (10.5%) patients progressed
to ESLD, 22 of them among the coinfected. HIV infection was a strong
determinant of negative outcome. Cumulative incidence of ESLD was higher in
HCV/HIC coinfected than in HCV monoinfected patients irrespectively of the
years passed from HCV seroconversion.Immune recovery after HAART initiation in
coinfected patients resulted in significant reduction (81,9%) of cause specific
hazard for ESLD (p=0.001). Conclusions: Greek Haemophilia patients present a
high incidence of HCV infection and CHC. The cumulative incidence of ESLD 30
years after HCV infection is relatively low, but higher among coinfected
patients. An early and potent anti-HIV therapy in this group or patients,
before the occurrence of immunosupression, may reduce the rate of HCV morbidity
and mortality.
Keywords:
Haemophilia, Hepatitis C, HIV infection, End stage liver disease, HAART
