Morbidity and mortality in paid Austrian plasma donors infected with hepatitis C at plasma donation in the 1970s.
OBJECTIVE
Between 1964 and 1987 several epidemic outbreaks of hepatitis C virus infection linked to plasma donation occurred at plasmapheresis centres in Austria. Data collected by a Foundation to help the victims enabled us to study the natural history of chronic hepatitis C in this cohort.


METHODS
Medical records and charts of donors accepted by the Foundation were analyzed.


RESULTS
Four hundred and eighty-five subjects (439 males; mean age at infection: 22 years) were included. Mean follow-up was 31 years. Thirty-four percent of plasma donors had advanced liver disease; alcohol abuse and diabetes were related to progression. Twenty-one patients developed hepatocellular carcinoma; 36 underwent liver transplantation. Six donors cleared the virus spontaneously. Forty died, with death directly related to liver disease in 25 donors. Overall and transplant-free 35-year cumulative survival rates were 84% and 74%, respectively. Three hundred and nineteen patients received and 291 completed antiviral treatment. All 56 who achieved a sustained virologic response are alive and well; 14 non-responders died and nine underwent liver transplantation.


CONCLUSIONS
Thirty-one years after virus infection, advanced liver disease has developed in a third of patients, with an overall mortality of 7%. These data underline the progressive nature of chronic hepatitis C infection and the need to identify and treat infected subjects.
Ferenci
Peter
P
Department of Internal Medicine IV, Medical University of Vienna, Austria. peter.ferenci@meduniwien.ac.at
Ferenci
Stefan
S
Datz
Christian
C
Rezman
Ingo
I
Oberaigner
Wilhelm
W
Strauss
Reinhild
R
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001317:Austria / Q000453:epidemiology; D001782:Blood Donors; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000635:transmission*; D006801:Humans; D008107:Liver Diseases / Q000401:mortality* / Q000517:prevention & control / Q000821:virology; D008297:Male; D009017:Morbidity; D016019:Survival Analysis
D000998:Antiviral Agents