June 11, 2013

Hep C poorly managed in haemophiliacs

Gastroenterology Update 11 JUNE 2013

Hugo Wilcken

People with inherited bleeding disorders are not being adequately monitored for hepatitis C, despite high levels found in those screened, say Australian experts.

Only 61% had been tested for hepatitis C, the researchers found in a study of 700 patients with bleeding disorders born after 1992.

Of those who had been tested, over half were hepatitis C antibody positive, with prevalence approaching 100% in patients with severe bleeding disorders.

But of those found to be positive, only a third had actually been treated, with a response rate of 45%.

Around 30% of patients with hepatitis C had had no follow-up with a clinician in the previous two years, the authors from the Alfred Hospital in Melbourne found.

A fifth of the 220 patients with hepatitis had died, including four from hepatocellular carcinoma and four from other liver-related complications. Over a fifth of patients with hepatitis C had never seen a specialist for their viral infection, the authors found.

Reporting in Haemophilia, the authors said high rates of disease in this population were largely due to exposure through blood transfusion before 1992, when blood products were first screened for the virus.

The authors said without testing, many of these patients would remain asymptomatic for years until irreversible complications set in.

But there was no comprehensive database to determine which patients might have received infected blood products, they noted, and patient self-reporting was a poor alternative as the blood may have been given to them as small children.

“Given the substantial morbidity and mortality associated with hepatitis C and new therapeutic options becoming available, it seems important to reengage patients to diagnose, offer treatment and monitor this infection,” they concluded.

Haemophilia 2013; online

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