Outcome in a hepatitis C (genotype 1b) single source outbreak in Germany—a 25-year multicenter study

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. Between August 1978 and March 1979, 14 HCV-1b contaminated batches of anti-D immunogl...

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Bibliographic Details
Published in:Journal of hepatology 2005-10, Vol.43 (4), p.590-598
Main Authors: Wiese, Manfred, Grüngreiff, Kurt, Güthoff, Wolfgang, Lafrenz, Michael, Oesen, Ute, Porst, Heiner
Format: Article
Language:English
Subjects:
Adult
Age of Onset
Alcohol Drinking
Anti-HCV
Carcinoma, Hepatocellular - epidemiology
Disease Outbreaks
Female
Fibrosis
Genotype
Germany - epidemiology
HCV genotypes
Hepacivirus - genetics
Hepatitis C
Hepatitis C - complications
Hepatitis C - epidemiology
Histology
Humans
Liver cirrhosis
Liver Cirrhosis - epidemiology
Liver Neoplasms - epidemiology
Male
Middle Aged
Natural history
Outcome
PCR
Risk Factors
Viral Load
Virology
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Summary: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. 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. 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 precirrhotic 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. 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.
ISSN:0168-8278
1600-0641
DOI:10.1016/j.jhep.2005.04.007