Clinical outcomes after hepatitis C infection from contaminated anti-D immune globulin. Irish Hepatology Research Group.

Hdl Handle:
http://hdl.handle.net/10147/209155
Title:
Clinical outcomes after hepatitis C infection from contaminated anti-D immune globulin. Irish Hepatology Research Group.
Authors:
Kenny-Walsh, E
Affiliation:
Cork University Hospital, Ireland.
Citation:
N Engl J Med. 1999 Apr 22;340(16):1228-33.
Journal:
The New England journal of medicine
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209155
DOI:
10.1056/NEJM199904223401602
PubMed ID:
10210705
Abstract:
BACKGROUND AND METHODS: In February 1994, batches of anti-D immune globulin used in Ireland during 1977 and 1978 to prevent Rh isoimmunization were found to be contaminated with hepatitis C virus (HCV) from a single infected donor. In March 1994, a national screening program was initiated for all women who had received anti-D immune globulin between 1970 and 1994. Of the 62,667 women who had been screened when this study began, 704 (1.1 percent) had evidence of past or current HCV infection, and 390 of those 704 (55 percent) had positive tests for serum HCV RNA on reverse-transcription-polymerase-chain-reaction analysis. All 390 were offered a referral for clinical assessment and therapy. We evaluated 376 of these 390 women (96 percent); the other 14 were not seen at one of the designated treatment centers. RESULTS: The mean (+/-SD) age of the 376 women was 45+/-6 years at the time of screening. They had been infected with hepatitis C for about 17 years. A total of 304 women (81 percent) reported symptoms, most commonly fatigue (248 [66 percent]). Serum alanine aminotransferase concentrations were slightly elevated (40 to 99 U per liter) in 176 of 371 women (47 percent), and the concentrations were 100 U per liter or higher in 31 (8 percent). Liver biopsies showed inflammation in 356 of 363 women (98 percent); in most cases the inflammation was slight (41 percent) or moderate (52 percent). Although the biopsy samples from 186 of the 363 women (51 percent) showed evidence of fibrosis, only 7 women (2 percent) had probable or definite cirrhosis. Two of the seven reported excessive alcohol consumption. CONCLUSIONS: Most of the women with HCV infection 17 years after receiving HCV-contaminated anti-D immune globulin had evidence of slight or moderate hepatic inflammation on liver biopsy, about half had fibrosis, and 2 percent had probable or definite cirrhosis.
Language:
eng
MeSH:
Adult; Alanine Transaminase/blood; Biopsy; Disease Outbreaks; Disease Progression; *Drug Contamination; Female; Hepacivirus/isolation & purification; Hepatitis C, Chronic/diagnosis/epidemiology/*etiology/pathology; Humans; Ireland/epidemiology; Liver/*pathology; Liver Cirrhosis/etiology/pathology; Mass Screening; Middle Aged; RNA, Viral/blood; Rho(D) Immune Globulin/*therapeutic use; Risk Factors
ISSN:
0028-4793 (Print); 0028-4793 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorKenny-Walsh, Een_GB
dc.date.accessioned2012-02-03T15:13:43Z-
dc.date.available2012-02-03T15:13:43Z-
dc.date.issued2012-02-03T15:13:43Z-
dc.identifier.citationN Engl J Med. 1999 Apr 22;340(16):1228-33.en_GB
dc.identifier.issn0028-4793 (Print)en_GB
dc.identifier.issn0028-4793 (Linking)en_GB
dc.identifier.pmid10210705en_GB
dc.identifier.doi10.1056/NEJM199904223401602en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209155-
dc.description.abstractBACKGROUND AND METHODS: In February 1994, batches of anti-D immune globulin used in Ireland during 1977 and 1978 to prevent Rh isoimmunization were found to be contaminated with hepatitis C virus (HCV) from a single infected donor. In March 1994, a national screening program was initiated for all women who had received anti-D immune globulin between 1970 and 1994. Of the 62,667 women who had been screened when this study began, 704 (1.1 percent) had evidence of past or current HCV infection, and 390 of those 704 (55 percent) had positive tests for serum HCV RNA on reverse-transcription-polymerase-chain-reaction analysis. All 390 were offered a referral for clinical assessment and therapy. We evaluated 376 of these 390 women (96 percent); the other 14 were not seen at one of the designated treatment centers. RESULTS: The mean (+/-SD) age of the 376 women was 45+/-6 years at the time of screening. They had been infected with hepatitis C for about 17 years. A total of 304 women (81 percent) reported symptoms, most commonly fatigue (248 [66 percent]). Serum alanine aminotransferase concentrations were slightly elevated (40 to 99 U per liter) in 176 of 371 women (47 percent), and the concentrations were 100 U per liter or higher in 31 (8 percent). Liver biopsies showed inflammation in 356 of 363 women (98 percent); in most cases the inflammation was slight (41 percent) or moderate (52 percent). Although the biopsy samples from 186 of the 363 women (51 percent) showed evidence of fibrosis, only 7 women (2 percent) had probable or definite cirrhosis. Two of the seven reported excessive alcohol consumption. CONCLUSIONS: Most of the women with HCV infection 17 years after receiving HCV-contaminated anti-D immune globulin had evidence of slight or moderate hepatic inflammation on liver biopsy, about half had fibrosis, and 2 percent had probable or definite cirrhosis.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAlanine Transaminase/blooden_GB
dc.subject.meshBiopsyen_GB
dc.subject.meshDisease Outbreaksen_GB
dc.subject.meshDisease Progressionen_GB
dc.subject.mesh*Drug Contaminationen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHepacivirus/isolation & purificationen_GB
dc.subject.meshHepatitis C, Chronic/diagnosis/epidemiology/*etiology/pathologyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIreland/epidemiologyen_GB
dc.subject.meshLiver/*pathologyen_GB
dc.subject.meshLiver Cirrhosis/etiology/pathologyen_GB
dc.subject.meshMass Screeningen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshRNA, Viral/blooden_GB
dc.subject.meshRho(D) Immune Globulin/*therapeutic useen_GB
dc.subject.meshRisk Factorsen_GB
dc.titleClinical outcomes after hepatitis C infection from contaminated anti-D immune globulin. Irish Hepatology Research Group.en_GB
dc.contributor.departmentCork University Hospital, Ireland.en_GB
dc.identifier.journalThe New England journal of medicineen_GB
dc.description.provinceMunster-

Related articles on PubMed

All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.