title: Long-term follow-up among Danish transfusion recipients identified in the national hepatitis C lookback.
abstract: BACKGROUND
  In 1996, a national lookback study was performed in Denmark identifying 1018 patients exposed to hepatitis C virus (HCV) by transfusion before 1991. The objective of this study was to describe morbidity and mortality during extended follow-up among patients in the Danish HCV lookback cohort alive in 1996.
  
  
  METHODS
  In a retrospective cohort study of 230 patients exposed to HCV by blood transfusion and alive in 1996 we extracted data from national registers and compared these with a matched group of unexposed transfusion recipients.
  
  
  RESULTS
  Among 230 HCV-exposed recipients alive in 1996, 124 (53.9%) had chronic hepatitis C, 43 (18.7%) were not infected, and 63 (27.4%) had incomplete HCV data. In 2009, 121 (52.6%) were still alive a median of 21.8 years after transfusion. The mortality rate among the HCV-exposed recipients followed from 1996 was 4.9 per 100 person-years (PY). The incidence of liver cirrhosis and decompensated cirrhosis was 1.0 per 100 PY and 0.4 per 100 PY, respectively; 16.5% had cirrhosis at death. Among HCV-exposed recipients, no difference in all-cause or liver-related mortality was observed between HCV-infected and HCV-uninfected recipients. Further, there was no difference in mortality between HCV-exposed and -unexposed transfusion recipients (mortality rate ratio [MRR], 1.06; 95% confidence interval [CI], 0.96-1.17; p = 0.47), but liver-related mortality was significantly higher among HCV-exposed patients (MRR, 10.0; 95% CI, 7.20-17.7; p < 0.001).
  
  
  CONCLUSIONS
  Two decades after exposure to blood products from HCV-infected donors, only 121(11.8%) of 1018 recipients remained alive. For HCV-exposed recipients no excess all-cause mortality was observed, but liver-related mortality was significantly increased.
authors: Department of Clinical Immunology, Odense University Hospital, Odense, Denmark. saj@dadlnet.dk
authors: Søren Andreas
authors: SA
authors: Just
authors: Katrine
authors: K
authors: Grau
authors: Jørgen
authors: J
authors: Georgsen
authors: Nina
authors: N
authors: Weis
authors: Susan
authors: S
authors: Cowan
authors: Karin
authors: K
authors: Groenbaek
authors: Henrik
authors: H
authors: Krarup
authors: Peer Brehm
authors: PB
authors: Christensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000097:blood / Q000401:mortality* / Q000635:transmission*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008103:Liver Cirrhosis / Q000097:blood / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D065227:Transfusion Reaction; D055815:Young Adult