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

Abstract

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.