Follow up of the 987 blood donors found with hepatitis C virus infection over 9–18 years
Article first published online: 8 MAR 2012
© 2012 The Japan Society of Hepatology
Volume 42, Issue 7, pages 637–647, July 2012
How to Cite
Matsuo, J., Mizui, M., Okita, H., Katayama, K., Aimitsu, S., Sakata, T., Obayashi, M., Nakanishi, T., Chayama, K., Miyakawa, Y., Yoshizawa, H., Tanaka, J. and for the Hiroshima Hepatitis Study Group (2012), Follow up of the 987 blood donors found with hepatitis C virus infection over 9–18 years. Hepatology Research, 42: 637–647. doi: 10.1111/j.1872-034X.2012.00966.x
- Issue published online: 12 JUN 2012
- Article first published online: 8 MAR 2012
- Accepted manuscript online: 12 JAN 2012 09:53AM EST
- Received 7 November 2011; revision 16 December 2011; accepted 4 January 2012.
- alanine aminotransferase;
- chronic hepatitis C;
- hepatitis C virus;
- hepatocellular carcinoma;
- natural history
Aim: 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.
Conclusion: 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.