Hepatitis C virus in long-term bone marrow transplant survivors

Ivantes, Claudia Alexandra Pontes; Amarante, Heda Maria Barska dos Santos; Ioshii, Sérgio Ossamu; Pasqüini, Ricardo

doi:10.1038/sj.bmt.1704519

Cited by 29 publications

(27 citation statements)

References 20 publications

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“…A couple of long-term follow-up studies analyzing retrospectively the outcome of HCV-infected patients have been published. 3,4 Our study differs from the previously published studies by being prospective including a cohort of patients registered in the study between 1993 and 1996 and followed for 15 years. In addition, the study is significantly larger than the previously published studies both regarding the number of patients included and in the number of patients receiving antiviral therapy against HCV.…”

Section: Discussioncontrasting

confidence: 38%

“…In another small single-center study, 13.6% were reported to have liver cirrhosis. 4 The reported annual progression rate to severe complications in a large, retrospective study of HCV-infected individuals was 0.8% in patients who did receive antiviral therapy and 3.7% in patients without such therapy. 11 In an epidemiological review of patients with HCV, the reviewed information reported that 20% of patients would develop liver cirrhosis over a period of 20 --25 years 12 suggesting that our rate of 11.7% at 20 years after HSCT, and probably in many patients longer time since infection, does not represent a substantial difference compared with other nontransplanted HCV-infected populations.…”

Section: Discussionmentioning

confidence: 99%

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Long-term follow-up of HCV-infected hematopoietic SCT patients and effects of antiviral therapy

Ljungman

Locasciulli²,

Soria

et al. 2011

Bone Marrow Transplant

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This prospective study was initiated in 1993 with the aim to study late effects and responses to antiviral therapy in a cohort of hepatitis C virus (HCV)-infected patients. A total of 195 patients were included from 12 centers. In all, 134 patients had undergone allogeneic and 61 autologous hematopoietic SCT (HSCT). The median follow-up from HSCT is currently 16.8 years and the maximum 27.2 years. Overall 33 of 195 patients have died of which 6 died from liver complications. The survival probability was 81.6% and the cumulative incidence for death in liver complications was 6.1% at 20 years after HSCT. The cumulative incidence of severe liver complications (death from liver failure, cirrhosis and liver transplantation) was 11.7% at 20 years after HSCT. In all, 85 patients have been treated with IFN; 42 in combination with ribavirin. The sustained response rate was 40%. The rates of severe side effects were comparable to other patient populations and no patient developed significant exacerbations of GVHD. Patients receiving antiviral therapy had a trend toward a decreased risk of severe liver complications (odds ratio ¼ 0.33; P ¼ 0.058). HCV infection is associated with morbidity and mortality in long-term survivors after HSCT. Antiviral therapy can be given safely and might reduce the risk for severe complications.

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Section: Discussioncontrasting

confidence: 38%

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of HCV-infected hematopoietic SCT patients and effects of antiviral therapy

Ljungman

Locasciulli²,

Soria

et al. 2011

Bone Marrow Transplant

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“…Aetiology includes iron overload, 7,12,13 chronic viral hepatitis B and/ or C, 8,9,14 and chronic GVHD. 11 A few patients have autoimmune hepatitis and in some patients the cause of elevated liver enzymes is unknown.…”

Section: Introductionmentioning

confidence: 99%

Abnormal liver enzymes 2 years after haematopoietic stem cell transplantation in children: prevalence and risk factors

Bresters

Gils

Dekker

et al. 2007

Bone Marrow Transplant

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To establish the prevalence of elevated liver enzymes in children transplanted in a Dutch haematopoietic stem cell transplantation (HSCT) centre, we retrospectively assessed AST and ALT values at 2 years after HSCT. Age, sex, diagnosis, type of transplant, conditioning regimen and early post-transplant complications involving the liver (veno-occlusive disease, acute GVHD, viral reactivation) were analysed as risk factors. AST and ALT values were available at 2 years after HSCT in 216 of 290 patients (75%) alive at that time and were above normal in 53 (25%) and at least twice normal in 17 (8%) patients. Older age at HSCT and a diagnosis of benign haematological disease are risk factors for abnormal liver enzymes late after HSCT. In half of the patients with benign haematological disease, iron overload is the most likely aetiological factor. Chronic hepatitis B or C is uncommon in our centre. In conclusion, the prevalence of abnormal liver enzymes late after HSCT in our centre is lower than reported in previous studies. Abnormal liver enzymes occur more often in children who are older at HSCT and transplanted for benign haematological disease. Longterm follow-up is crucial to establish if elevated liver enzymes precede clinical liver disease.

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“…[5][6][7][8][9] The World Health Organization (WHO) data suggests a worldwide prevalence of 2.2%-3.0%, with the highest prevalence found in the African and the Eastern Mediterranean regions. 10 Brazilian studies on this subject have been predominantly targeted risk groups [11][12][13][14] and blood donors. 15,16 Only few investigators have addressed the prevalence of hepatitis C in the general population or in minority groups.…”

Section: Introductionmentioning

confidence: 99%

High prevalence of hepatitis C associated with familial history of hepatitis in a small town of south Brazil: efficiency of the rapid test for epidemiological survey

Ivantes¹,

Silva²,

Messias-Reason³

2010

Braz J Infect Dis

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This report describes a cross-sectional survey on the prevalence of hepatitis C antibodies (anti-HCV) in Tamboara, a small community in the northwest area from Paraná State, south of Brazil with a high rate of accumulated detection for HCV. Eight hundred and sixteen residents (17.87% from all the population), independently of the age and time living in Tamboara were included in this study by an epidemiologic questionnaire and by testing for anti-HCV. The rapid immuno-chromatographic test was applied for detection of HCV antibodies. The anti-HCV prevalence by rapid test was 4.28%. The median age for positive and negative test was 60.49 ± 14.14 and 41.67 ± 20.25, respectively (p < 0.001). By multivariate analysis, only familial history of hepatitis (p = 0.001; OR = 6.41; CI 95% = 2.08-19.78) and age (p = 0.007; OR 1.06;95% CI = 1.02-1.10) showed statistical significance for positive anti-HCV. The rapid test sensitivity and specificity were 100% and 92.7% respectively, with an accuracy of 95.8% (95% CI = 91-100). These findings demonstrated a high prevalence of anti-HCV in Tamboara. The familial history of hepatitis was a significant risk factor to the infection and HCV rapid test showed to be accurate and feasible for epidemiological surve

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Hepatitis C virus in long-term bone marrow transplant survivors

Cited by 29 publications

References 20 publications

Long-term follow-up of HCV-infected hematopoietic SCT patients and effects of antiviral therapy

Long-term follow-up of HCV-infected hematopoietic SCT patients and effects of antiviral therapy

Abnormal liver enzymes 2 years after haematopoietic stem cell transplantation in children: prevalence and risk factors

High prevalence of hepatitis C associated with familial history of hepatitis in a small town of south Brazil: efficiency of the rapid test for epidemiological survey

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