Outcome in a hepatitis C (genotype 1b) single source outbreak in Germany--a 25-year multicenter study.
OBJECTIVE
The natural course of the hepatitis C virus genotype 1b (HCV-1b) infection is still unclear but important for therapeutic decisions. There are few unbiased long-term follow-up studies with known dates of infection.


METHODS
Between August 1978 and March 1979, 14 HCV-1b contaminated batches of anti-D immunoglobulin had been administered to 2867 women for prophylaxis of rhesus isoimmunization throughout East Germany. We reexamined 1980 women, representing 70% of the total cohort of 15 centers.


RESULTS
After application of the contaminated anti-D, 93% of the recipients developed an acute hepatitis C. After 25 years, 86% of the 1833 affected women still tested positive for hepatitis C virus antibodies and 46% for HCV RNA. Only nine (0.5%) had overt liver cirrhosis, 30 women (1.5%) developed pre-cirrhotic stages and one HCC was diagnosed. Ten (0.5%) died of HCV related complications, half of these related to additional comorbidity. In the last 5 years, a continuous, but low increase of fibrotic scores was observed.


CONCLUSIONS
Young women without comorbidity may clear HCV (1b) infection in more than half of the cases, or develop mild chronic hepatitis C. We confirmed the low risk of progression to cirrhosis in this cohort within 25 years.
Wiese
Manfred
M
University Affiliated Hospital St. Georg, Leipzig, Germany. wiese@sanktgeorg.de <wiese@sanktgeorg.de>
Grüngreiff
Kurt
K
Güthoff
Wolfgang
W
Lafrenz
Michael
M
Oesen
Ute
U
Porst
Heiner
H
D000328:Adult; D017668:Age of Onset; D000428:Alcohol Drinking; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D005858:Germany / Q000453:epidemiology; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D019562:Viral Load