PB1242 - HCV infection in people with coagulopathies: a retrospective study.

Background: People with hereditary bleeding disorders (PWHBD) have a high prevalence of infections transmitted by blood transfusion. Despite advances in treatment, with recombinant products and safer blood components/blood products, these infections represent a significant complication in this population. According to the World Health Organization (WHO), approximately 58 million people worldwide have been infected with HCV. In 2019, it was estimated that 290,000 die annually from HCV complications.

Aims: To describe the prevalence of HCV infection in PWHBD born before 1992, the types of treatment with respective responses and complications arising from hepatitis.

Methods: Retrospective study with data from medical records of a Hemophilia center.

Results: A total of 374 PWHBD were born before 1992 and of these, 123 (32.9%) were HCV positive. We evaluated 116 people from this cohort and these, 23 (19.8%) presented spontaneous HCV clearance. Of the remaining 93 people, 22 (23.6%) did not undergo any treatment, despite being referred to the hepatology service. Of the 71 who underwent treatment, 46 (64.8%) were initially treated with IFN or INF/PegIFN-Ribavirin and these, 28 had no response or did not tolerate the treatment. Eighteen these were treated with direct antivirals and all achieved sustained response. Twenty-three underwent the first treatment with direct antiviral and these, 15 completed treatment, all with a sustained response. Treatment with direct antivirals showed a response rate >90% and all who completed treatment had a sustained viral response. Complications developed 31/123: cirrhosis (17), hepatocellular carcinoma (02), other complications (12).

Conclusion(s): The prevalence of HCV infection was similar to that in other hemophilia centers in Brazil, where people were treated in the past with blood products, with little or no screening for the virus. After the introduction of mandatory control for HCV since 1993, there was a drastic reduction in the contamination of these patients.