Original Article

You have full text access to this OnlineOpen article

Long-term mortality and morbidity of transfusion-associated non-A, non-B, and type C hepatitis: A National Heart, Lung, and Blood Institute collaborative study

  1. Leonard B. Seeff M.D.1,2,*,
  2. F. Blaine Hollinger3,
  3. Harvey J. Alter4,
  4. Elizabeth C. Wright5,
  5. Casey M. B. Cain6,
  6. Zelma J. Buskell1,
  7. Kamal G. Ishak7,
  8. Frank L. Iber8,
  9. Doris Toro9,
  10. Arun Samanta10,
  11. Ronald L. Koretz11,
  12. Robert P. Perrillo12

Article first published online: 30 DEC 2003

DOI: 10.1053/jhep.2001.21905

Issue

Hepatology

Hepatology

Volume 33, Issue 2, pages 455–463, February 2001

Additional Information

How to Cite

Seeff, L. B., Hollinger, F. B., Alter, H. J., Wright, E. C., Cain, C. M. B., Buskell, Z. J., Ishak, K. G., Iber, F. L., Toro, D., Samanta, A., Koretz, R. L. and Perrillo, R. P. (2001), Long-term mortality and morbidity of transfusion-associated non-A, non-B, and type C hepatitis: A National Heart, Lung, and Blood Institute collaborative study. Hepatology, 33: 455–463. doi: 10.1053/jhep.2001.21905

Author Information

  1. 1

    The Veterans Affairs Medical Centers, Washington, DC

  2. 2

    Georgetown University School of Medicine, Washington, DC

  3. 3

    Baylor College of Medicine, Houston, TX

  4. 4

    National Institutes of Health, Department of Transfusion Medicine, Bethesda, MD

  5. 5

    New England Research Institutes, Watertown, MA

  6. 6

    Westat, Rockville, MD

  7. 7

    Armed Forces Institute of Pathology, Washington, DC

  8. 8

    Hines, IL

  9. 9

    San Juan, Puerto Rico

  10. 10

    East Orange, NJ

  11. 11

    Olive View Med. Ctr., Sylmar, CA

  12. 12

    Ochsner Clinic, New Orleans, LA

*NIDDK, National Institutes of Health, 31 Center Drive, Rm: 9A-18, Bethesda, MD 20892-2560. fax: 301-480-7926.

Publication History

  1. Issue published online: 30 DEC 2003
  2. Article first published online: 30 DEC 2003
  3. Manuscript Accepted: 27 NOV 2000
  4. Manuscript Received: 6 SEP 2000

Funded by

  • NHLBI Contracts. Grant Numbers: NO1-HB-87047, NO1-HB-37093

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

Get PDF (174K)

Abstract

Persons with non-A, non-B hepatitis (cases) identified in 5 transfusion studies in the early 1970s have been followed ever since and compared for outcome with matched, transfused, non-hepatitis controls from the same studies. Previously, we reported no difference in all-cause mortality but slightly increased liver-related mortality between these cohorts after 18 years follow-up. We now present mortality and morbidity data after approximately 25 years of follow-up, restricted to the 3 studies with archived original sera. All-cause mortality was 67% among 222 hepatitis C-related cases and 65% among 377 controls (P = NS). Liver-related mortality was 4.1% and 1.3%, respectively (P = .05). Of 129 living persons with previously diagnosed transfusion-associated hepatitis (TAH), 90 (70%) had proven TAH-C, and 39 (30%), non-A-G hepatitis. Follow-up of the 90 TAH-C cases revealed viremia with chronic hepatitis in 38%, viremia without chronic hepatitis in 39%, anti-HCV without viremia in 17%, and no residual HCV markers in 7%. Thirty-five percent of 20 TAH-C patients biopsied for biochemically defined chronic hepatitis displayed cirrhosis, representing 17% of all those originally HCV-infected. Clinically evident liver disease was observed in 86% with cirrhosis but in only 23% with chronic hepatitis alone. Thirty percent of non-A, non-B hepatitis cases were unrelated to hepatitis viruses A,B,C, and G, suggesting another unidentified agent. In conclusion, all-cause mortality approximately 25 years after acute TAH-C is high but is no different between cases and controls. Liver-related mortality attributable to chronic hepatitis C, though low (<3%), is significantly higher among the cases. Among living patients originally HCV-infected, 23% have spontaneously lost HCV RNA.

Get PDF (174K)