Hep C Discussion Forum

Hm, we have entered into this topic before ... what about those of us who, out of medical necessity and via deemed "best practices" of the times, received not transfusions per say, but various forms of "immunoglobulins" , see (U.K. Tainted Blood Inquiry), see (Viet Nam era veterans/ They gave us this monster!!)  in the 70's (or later) when they so poorly addressed and slowly solved the "scandalous contaminated blood products problem"!? ... as well, this (below) also aligns itself with another topic we have pondered, about clearance and the curious (prison inmate) "super-clearers" see ( Super-clearers ) ...

This shameful Irish "story" is a hard and sad one, there can never be a happy ending, the women who are still surviving, ironically (if not outrageously), serve to be subjects of study still (thank you) to tell researchers things like why one should not drink (given the situ, duh) and perhaps hope in the gaining of understanding as to why there was a higher than average percentage of these women who did manage to spontaneously resolve their HCV.

Published in Gastroenterology - Journal Scan / Research · November 30, 2017

HCV-Related Complications Increased With Time in Cohort of Irish Women

Journal of Hepatology

TAKE-HOME MESSAGE

·         In this study, women diagnosed with HCV infection after taking contaminated anti-D immunoglobulin were followed. The complications of hepatitis C in this population were found to accelerate over time. The risk for liver-related complications doubled over a 5-year follow-up among women infected with HCV at a young age. These data suggest that fibrosis in hepatitis C does not progress at a linear and predictable rate, and progression changes with age and additional risk factors (eg, diabetes and alcohol consumption).

·         Patients with chronic HCV infection should be advised of the harmful effects of alcohol consumption on their health. Further follow-up is needed to evaluate the effectiveness of antiviral treatments during the rapidly progressing period of HCV infection.

- Eric Kallwitz, MD

BACKGROUND & AIM

In the mid-1990s, a group of Rh negative women was diagnosed with hepatitis C virus (HCV) genotype 1b infection, following administration of contaminated anti-D immunoglobulin in 1977-79. We aimed to describe their disease history and estimate the effect of selected host and treatment factors on disease progression.

METHODS

We conducted a cohort study on the women infected with HCV. Information was collected from records at seven HCV treatment centres on demographics, treatment and health outcomes up to the 31st December 2013. We calculated cumulative incidence, case fatality, and sub hazard ratios (SHR) for disease progression using competing risks regression.

RESULTS

Six hundred and eighty-two patients were included in the study. Among the chronically infected patients (n=374), 35% completed interferon-based antiviral treatment; 42% of whom had a sustained virological response. At the end of 2013, 19%, 1.9%, and 4.9% of chronically infected patients had developed cirrhosis, hepatocellular carcinoma, and liver-related death, respectively, compared with 10%, 0.8%, and 2.4% at the end of 2008. At the end of 2013, 321 (86%) of the chronically infected patients remained alive, 247 (77%) of whom were still chronically infected. Factors associated with increased cirrhosis rates included high alcohol intake (aSHR=4.9 [2.5-9.5]) and diabetes mellitus (aSHR=5.0 [2.9-8.8]).

CONCLUSIONS

Development of liver-related outcomes accelerated with time, with the risk of cirrhosis, hepatocellular carcinoma, and liver-related death doubling in the last five years of follow-up, particularly in women with high alcohol consumption and diabetes mellitus. We recommend that patients with chronic HCV infection be advised of the additive harmful effect of alcohol, and that data be collected on this cohort after a further five years to analyse the effect of subsequent antiviral treatment during this rapidly evolving period in HCV treatment history.

LAY SUMMARY

In the mid-1990s, a group of women were diagnosed with chronic hepatitis C virus (HCV) infection following receipt of contaminated anti-D immunoglobulin between 1977 and 1979 in Ireland. Seventy-two (19%) developed cirrhosis and 18 had died from liver-related causes (5%) after 36years of infection. Disease progression accelerated in the last five years of follow-up, particularly in women with diabetes mellitus and high alcohol consumption. We recommend that patients with chronic HCV infection be advised of the additive harmful effect of high alcohol consumption.

https://www.irishtimes.com/news/health/living-with-a-time-bomb-1.29550

Trinity Scientists Launch New Study to Discover How "Super" Immune ... www.universitytimes.ie/.../trinity-scientists-launch-new-study-to-discover-how-super-i...

http://imj.ie/long-term-follow-up-of-patients-with-spontaneous-clearance-of-hepatitis-c-does-viral-clearance-mean-cure/