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The elevated prevalence of risk factors for chronic liver disease among ageing people with hemophilia and implications for treatment

Qvigstad, Christian ; Tait, Robert Campbell ; Rauchensteiner, Stephan ; Berntorp, Erik LU ; de Moerloose, Philippe ; Schutgens, Roger E. and Holme, Pål Andre (2018) In Medicine 97(39).
Abstract

Chronic liver disease (CLD) is frequently seen in the hemophilia population. The ADVANCE Working Group conducted a cross-sectional study in which people with hemophilia (PWH) aged ≥40 years were included. This study aimed to assess the associations between CLD and its risk factors using data from the H3 study, and to suggest implications for optimal care.Data from 13 European countries were collected at a single time-point (2011-2013). Univariate and multivariate logistic regression (MLR) analyses were performed.A total of 532 PWH were included with either hemophilia A (n = 467) or hemophilia B (n = 65). A total of 127 (24%) were diagnosed with CLD. Hepatitis C virus (HCV), human immunodeficiency virus (HIV), total cholesterol, and... (More)

Chronic liver disease (CLD) is frequently seen in the hemophilia population. The ADVANCE Working Group conducted a cross-sectional study in which people with hemophilia (PWH) aged ≥40 years were included. This study aimed to assess the associations between CLD and its risk factors using data from the H3 study, and to suggest implications for optimal care.Data from 13 European countries were collected at a single time-point (2011-2013). Univariate and multivariate logistic regression (MLR) analyses were performed.A total of 532 PWH were included with either hemophilia A (n = 467) or hemophilia B (n = 65). A total of 127 (24%) were diagnosed with CLD. Hepatitis C virus (HCV), human immunodeficiency virus (HIV), total cholesterol, and severe hemophilia were significant risk factors in univariate logistic regressions. In MLR, HCV Ab+/PCR+ (OR = 17.6, P < .001), diabetes (OR = 3.0, P = .02), and HIV (OR = 1.9, P = .049) were positively associated with CLD. Total cholesterol (OR = 0.6, P = .002) was negatively associated with CLD. We found no evidence of interaction effects among the explanatory variables. No significant associations with age and type of or severity of hemophilia were observed in MLR.The main risk factors for CLD in this European cohort also apply to the general population, but the prevalence of HCV and HIV is considerably larger in this cohort. With new and improved treatment options, intensified eradication therapy for HCV seems justified to prevent CLD. Similarly, intensified monitoring and treatment of diabetes seem warranted.

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type
Contribution to journal
publication status
published
subject
in
Medicine
volume
97
issue
39
article number
e12551
publisher
Wolters Kluwer
external identifiers
  • pmid:30278553
  • scopus:85054384857
ISSN
1536-5964
DOI
10.1097/MD.0000000000012551
language
English
LU publication?
yes
id
c08e6bbb-d90f-4b34-8321-b0148c0a2501
date added to LUP
2018-11-05 12:16:03
date last changed
2020-10-20 03:35:10
@article{c08e6bbb-d90f-4b34-8321-b0148c0a2501,
  abstract     = {<p>Chronic liver disease (CLD) is frequently seen in the hemophilia population. The ADVANCE Working Group conducted a cross-sectional study in which people with hemophilia (PWH) aged ≥40 years were included. This study aimed to assess the associations between CLD and its risk factors using data from the H3 study, and to suggest implications for optimal care.Data from 13 European countries were collected at a single time-point (2011-2013). Univariate and multivariate logistic regression (MLR) analyses were performed.A total of 532 PWH were included with either hemophilia A (n = 467) or hemophilia B (n = 65). A total of 127 (24%) were diagnosed with CLD. Hepatitis C virus (HCV), human immunodeficiency virus (HIV), total cholesterol, and severe hemophilia were significant risk factors in univariate logistic regressions. In MLR, HCV Ab+/PCR+ (OR = 17.6, P &lt; .001), diabetes (OR = 3.0, P = .02), and HIV (OR = 1.9, P = .049) were positively associated with CLD. Total cholesterol (OR = 0.6, P = .002) was negatively associated with CLD. We found no evidence of interaction effects among the explanatory variables. No significant associations with age and type of or severity of hemophilia were observed in MLR.The main risk factors for CLD in this European cohort also apply to the general population, but the prevalence of HCV and HIV is considerably larger in this cohort. With new and improved treatment options, intensified eradication therapy for HCV seems justified to prevent CLD. Similarly, intensified monitoring and treatment of diabetes seem warranted.</p>},
  author       = {Qvigstad, Christian and Tait, Robert Campbell and Rauchensteiner, Stephan and Berntorp, Erik and de Moerloose, Philippe and Schutgens, Roger E. and Holme, Pål Andre},
  issn         = {1536-5964},
  language     = {eng},
  number       = {39},
  publisher    = {Wolters Kluwer},
  series       = {Medicine},
  title        = {The elevated prevalence of risk factors for chronic liver disease among ageing people with hemophilia and implications for treatment},
  url          = {http://dx.doi.org/10.1097/MD.0000000000012551},
  doi          = {10.1097/MD.0000000000012551},
  volume       = {97},
  year         = {2018},
}