Premium
Long‐term follow‐up among Danish transfusion recipients identified in the national hepatitis C lookback
Author(s) -
Just Søren Andreas,
Grau Katrine,
Georgsen Jørgen,
Weis Nina,
Cowan Susan,
Groenbaek Karin,
Krarup Henrik,
Christensen Peer Brehm
Publication year - 2012
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2011.03309.x
Subject(s) - medicine , cirrhosis , blood transfusion , hepatitis c , hepatitis c virus , cohort , incidence (geometry) , mortality rate , cohort study , confidence interval , retrospective cohort study , liver transplantation , gastroenterology , surgery , pediatrics , immunology , transplantation , virus , physics , optics
BACKGROUND: In 1996, a national lookback study was performed in Denmark identifying 1018 patients exposed to hepatitis C virus (HCV) by transfusion before 1991. The objective of this study was to describe morbidity and mortality during extended follow‐up among patients in the Danish HCV lookback cohort alive in 1996. STUDY DESIGN AND METHODS: In a retrospective cohort study of 230 patients exposed to HCV by blood transfusion and alive in 1996 we extracted data from national registers and compared these with a matched group of unexposed transfusion recipients. RESULTS: Among 230 HCV‐exposed recipients alive in 1996, 124 (53.9%) had chronic hepatitis C, 43 (18.7%) were not infected, and 63 (27.4%) had incomplete HCV data. In 2009, 121 (52.6%) were still alive a median of 21.8 years after transfusion. The mortality rate among the HCV‐exposed recipients followed from 1996 was 4.9 per 100 person‐years (PY). The incidence of liver cirrhosis and decompensated cirrhosis was 1.0 per 100 PY and 0.4 per 100 PY, respectively; 16.5% had cirrhosis at death. Among HCV‐exposed recipients, no difference in all‐cause or liver‐related mortality was observed between HCV‐infected and HCV‐uninfected recipients. Further, there was no difference in mortality between HCV‐exposed and ‐unexposed transfusion recipients (mortality rate ratio [MRR], 1.06; 95% confidence interval [CI], 0.96‐1.17; p = 0.47), but liver‐related mortality was significantly higher among HCV‐exposed patients (MRR, 10.0; 95% CI, 7.20‐17.7; p < 0.001). CONCLUSION: Two decades after exposure to blood products from HCV‐infected donors, only 121(11.8%) of 1018 recipients remained alive. For HCV‐exposed recipients no excess all‐cause mortality was observed, but liver‐related mortality was significantly increased.