Bericht über dramatischen Anstieg von Lebertumoren

verursacht durch chronische Hepatitis C Infektionen


Bericht über dramatischen Anstieg von Lebertumoren
 
Über einen dramatischen Anstieg von Lebertumoren bei Hämophilen, verursacht durch  chronische Hepatitis C Infektionen berichteten Ärzte der Hämophiliebehandlungszentren von Frankfurt und Mainz auf dem im Juli in Genf stattgefundenen ISTH Kongress.
Von ungefähr 90 Patienten mit chronischer Hepatitis C Infektion erkrankten 7 Patienten in einem Beobachtungszeitraum von nur 15 Monaten an einem hepatozellulären Karzinom. Alle Patienten hatten zuerst eine Leberzirrhose entwickelt. Zwischen der Infektion mit dem Hepatitis C Virus und der Entwicklung des Tumors lagen im Durchschnitt 34 Jahre. Zwei der sieben Patienten sind leider an den Folgen der Tumorerkrankung inzwischen verstorben.
 
Kommentar: Auch in Thüringen verstarb erst vor wenigen Tagen ein Hämophiler an den Folgen seiner HCV Infektion. Diese dramatischen Zahlen belegen erneut, wie berechtigt die Forderungen der DHG nach einer Entschädigung für HCV infizierte Hämophile sind.
Dr. Uwe Schlenkrich
 
 
 
[P-W-115] RAPID INCREASE OF HEPATOCELLULAR CARCINOMA IN PATIENTS WITH    HAEMOPHILIA AND CHRONIC HCV- INFECTION                                   
                                                                            
   C. von Auer, S. Heinsdorf, M. Krause, W. Miesbach, I. Scharrer.          
   Haematology and Oncology, J. Gutenberg- University Hospital, Mainz;      
   Haemostaseology, J.W. Goethe-University Hospital, Frankfurt, Germany     
                                                                            
   Introduction: Hepatocellular carcinoma (HCC) is an increasingly          
   frequent cause of mortality in haemophiliacs with chronic hepatitis. In  
   recent years we have observed a rapid increase in HCC development in     
   our haemophilia treatment centre. We retrospectively analysed our data   
   to investigate the impact of chronic hepatitis C virus infection in      
   haemophilic patients nowadays.                                           
   Methods: In our centre we treated approximately 90 haemophilic patients  
   with chronic HCV hepatitis. Seven patients developed a HCC. Their data   
   were analyzed more detailed.                                             
   Results: Median age at estimated infection was 24,5 years, median age    
   at HCC detection was 60 years. HCV genotype was 1b (3), 3a (3), one      
   unknown. The median estimated time between HCV infection and HCC         
   development was 34 years. All patients had developed liver cirrhosis:    
   two Child-Pugh A, one Child-Pugh B and four Child-Pugh C. All were       
   regularly checked at least once a year in our centre with routine        
   screening of AFP level and periodic ultrasound (US) scans. HCC was       
   diagnosed either by elevated AFP levels and US findings (2) or MRT (2),  
   by MRT and check of arterial hypervascularisation (1) plus liver biopsy  
   (1). Two patients were co-infected (one with HIV, one with HIV and       
   chronic HBV infection). Four patients had been treated with interferon   
   alpha or peginterferon alone or in combination with ribavirin, only one  
   achieved a virologic response. Transcatheter arterial chemoembolization  
   was done repeatedly in three patients. Two patients died of hepatic      
   failure.                                                                 
   Conclusions: The detection of seven HCC in our centre in only 15 months  
   is striking. Our data confirm that HCC seems to be a more significant    
   secondary disease for haemophilic patients than was formerly             
   recognized. A close follow- up on haemophiliacs with chronic hepatitis   
   C should result in early detection and consequently more easily          
   treatable tumors and longer survival of our patients.                    
   von Auer C, Heinsdorf S, Krause M, Miesbach W, Scharrer I. RAPID         
   INCREASE OF HEPATOCELLULAR CARCINOMA IN PATIENTS WITH HAEMOPHILIA AND    
   CHRONIC HCV- INFECTION. J Thromb Haemost 2007; 5 Supplement 2: P-W-115