Hepatitis C anti D: progression with age?

Background: The current status of liver disease in women with Hepatitis C (HCV) infection secondary to contaminated anti D Immunoglobulin in 1977 has not been assessed.

Aims: To assess progression of liver disease in this unique group of patients.

Methods: We looked at rates of progression of liver disease, requirement for liver transplantation and mortality over a 10-year period in women with HCV infection secondary to anti D. 69 patients underwent at least 2 biopsies during the course of their disease. Mean interval between first and last biopsy was 6.1 years (range 0–10).

Results: There was no significant change in inflammation between first biopsy (mean inflammation score 1.2 [SEM 0.06]) and last biopsy (1.2[0.06]) (p=0.44). In contrast mean fibrosis score increased from 0.5 (SEM 0.1) to 1.0 (0.2) between first and last biopsy (p<0.001). Cirrhosis was evident in 3(3%) women within 3 years of diagnosis, 10(13%) within 10 years. 3(3%) women underwent liver transplantation and 4(4%) women died from HCV related complications over the 10 year period.

Conclusions: Our results highlight significant progression, morbidity and mortality in this patient group, although this disease does not appear to be as aggressive as non-anti D associated HCV infection.