title: Follow up of the 987 blood donors found with hepatitis C virus infection over 9-18 years.
abstract: OBJECTIVE
  To follow up blood donors found with hepatitis C virus (HCV) infection, to improve the outcome by antiviral treatments.
  
  
  METHODS
  Between 1991 and 2001, 3377 of the 1 925 860 donors (0.18%) were found to have HCV infection at the Hiroshima Red Cross Blood Center in Japan. Of them, 987 were able to be followed regularly over 9-18 years until 2009, and received antiviral treatments as required.
  
  
  RESULTS
  At the start, chronic hepatitis was diagnosed in 541 (54.8%), cirrhosis in five (0.5%) and hepatocellular carcinoma (HCC) in one (0.1%), whereas the remaining 439 (44.5%) had persistently normal aminotransferase levels (PNAL). Hospital visits were terminated voluntarily in 24.3% within the first year, 46.8% by 10 years and 50.9% by 17 years. Liver disease improved in 178 (18.0%), remained stable in 606 (61.4%) and aggravated in 170 (17.2%). Of the 541 donors with chronic hepatitis, HCC developed in 28 (5.2%) and cirrhosis in 11 (2.0%), whereas HCV infection was cleared in 107 (19.8%) by antiviral treatments. In addition, HCV infection resolved in 54 of the 439 donors (12.3%) with PNAL after they had developed chronic hepatitis and received treatments. In donors with chronic hepatitis, the cumulative incidence of HCC was 4.1% at 10 years. By multivariate analysis, age and diagnosis of chronic hepatitis at the entry were found to be independent risk factors for the development of HCC.
  
  
  CONCLUSIONS
  Individuals with undiagnosed HCV infection need to be identified and receive medical care. They have to be motivated to merit from this health-care program.
authors.affiliation: Department of Epidemiology, Infectious Disease Control and Prevention             Department of Medicine and Molecular Sciences, Graduate School of Biomedical Sciences, Hiroshima University             Hiroshima Red Cross Blood Center             Hiroshima Red Cross Hospital             National Hospital Organization Fukuyama Medical Center             Onomichi General Hospital             Miyoshi Chuo Hospital, Hiroshima             Hiroshima University, Hiroshima             Miyakawa Memorial Research Foundation, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Matsuo
authors.forename: Masaaki
authors.initials: M
authors.lastname: Mizui
authors.forename: Hajime
authors.initials: H
authors.lastname: Okita
authors.forename: Keiko
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authors.lastname: Katayama
authors.forename: Shiomi
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authors.lastname: Aimitsu
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Sakata
authors.forename: Makoto
authors.initials: M
authors.lastname: Obayashi
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakanishi
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Miyakawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshizawa
authors.forename: Junko
authors.initials: J
authors.lastname: Tanaka