Clinical outcomes after hepatitis C infection from contaminated anti-D immune globulin. Irish Hepatology Research Group.
Authors
Kenny-Walsh, EAffiliation
Cork University Hospital, Ireland.Issue Date
2012-02-03T15:13:43ZMeSH
AdultAlanine 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
Metadata
Show full item recordCitation
N Engl J Med. 1999 Apr 22;340(16):1228-33.Journal
The New England journal of medicineDOI
10.1056/NEJM199904223401602PubMed ID
10210705Abstract
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
engISSN
0028-4793 (Print)0028-4793 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1056/NEJM199904223401602
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