Background and Methods In February 1994, batches of anti-D immuneglobulin used in Ireland during 1977 and 1978 to prevent Rhisoimmunization were found to be contaminated with hepatitisC virus (HCV) from a single infected donor. In March 1994, anational screening program was initiated for all women who hadreceived anti-D immune globulin between 1970 and 1994. Of the62,667 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 serumHCV RNA on reverse-transcription–polymerase-chain-reactionanalysis. All 390 were offered a referral for clinical assessmentand therapy. We evaluated 376 of these 390 women (96 percent);the other 14 were not seen at one of the designated treatmentcenters.
Results The mean (±SD) age of the 376 women was 45±6years at the time of screening. They had been infected withhepatitis C for about 17 years. A total of 304 women (81 percent)reported symptoms, most commonly fatigue (248 women [66 percent]).Serum alanine aminotransferase concentrations were slightlyelevated (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 363women (98 percent); in most cases the inflammation was slight(41 percent) or moderate (52 percent). Although the biopsy samplesfrom 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 afterreceiving HCV-contaminated anti-D immune globulin had evidenceof slight or moderate hepatic inflammation on liver biopsy,about half had fibrosis, and 2 percent had probable or definitecirrhosis.
Source Information
From Cork University Hospital, Cork, Ireland (E.K.-W.).
Address reprint requests to Dr. Fergus Shanahan at the Department of Medicine, Cork University Hospital, Wilton, Cork, Ireland, or at fshanahan{at}bureau.ucc.ie.
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