Faculty of medicine and life sciences, KU Leuven, Belgium.
Faculty of health and life sciences, Hasselt University, Hasselt, Belgium.
Haemophilia. 2019 Nov;25(6):1028-1034. doi: 10.1111/hae.13829. Epub 2019 Aug 30.
Patients with haemophilia are one of the subgroups with a high prevalence of hepatitis C virus (HCV) infection. They are a potential target group to eliminate HCV infection thanks to the availability of direct-acting antiviral (DAA) therapy.
To investigate the results of DAA therapy in a cohort of patients with bleeding disorders.
This retrospective study was conducted between July 2018 and April 2019. All patients born before 1990 with haemophilia, von Willebrand factor Disease, factor V deficiency, factor VII deficiency or afibrinogenemia were included in this study.
Of 299 patients, 297 (99.3%) were tested for HCV antibody presence and 211 (71.0%) were positive. Of these, 205 (97.1%) were tested for HCV RNA and 153 (72.1%) were chronically infected. In total, 127 (83.0%) received antiviral therapy, and 110 (71.8%) patients were cured by antiviral treatment. The presence of cirrhosis was significantly higher in patients without a cure for HCV infection when compared to patients who achieved sustained virologic response by treatment or never infected (32.6% vs. 12.8% vs. 0%; P < .001). At the end of follow-up in 2019, only 14 (9.1%) patients had a remaining HCV infection. Ten (71.4%) were lost to follow-up, one (7.1%) patient refused, two (14.2%) had comorbidities and one (7.1%) will start treatment soon.
In this cohort, the elimination targets for HCV infection in 2030 as proposed by the World Health Organization were already reached. Nevertheless, in order to cure every patient, monitoring tools are necessary.
患有血友病的患者是丙型肝炎病毒（HCV）感染高发人群之一。由于直接作用抗病毒（DAA）治疗的出现，他们是消除 HCV 感染的潜在目标人群。
研究 DAA 治疗在出血性疾病患者队列中的结果。
本回顾性研究于 2018 年 7 月至 2019 年 4 月进行。本研究纳入所有出生于 1990 年前的血友病、血管性血友病、因子 V 缺乏症、因子 VII 缺乏症或无纤维蛋白原血症患者。
在 299 例患者中，297 例（99.3%）检测了 HCV 抗体，211 例（71.0%）阳性。其中，205 例（97.1%）检测了 HCV RNA，153 例（72.1%）为慢性感染。共有 127 例（83.0%）接受了抗病毒治疗，110 例（71.8%）患者经抗病毒治疗治愈。与未治愈 HCV 感染的患者相比，经治疗达到持续病毒学应答或从未感染的患者中肝硬化的发生率显著更高（32.6%比 12.8%比 0%；P<0.001）。2019 年随访结束时，仅有 14 例（9.1%）患者仍存在 HCV 感染。10 例（71.4%）患者失访，1 例（7.1%）患者拒绝，2 例（14.2%）患者合并其他疾病，1 例（7.1%）患者即将开始治疗。
在本队列中，已经达到了世界卫生组织 2030 年消除 HCV 感染的目标。然而，为了治愈每一位患者，需要监测工具。
