Researchers from the Royal Free Hospital and the University College Medical School, London, UK, monitored the long-term follow up of hemophilic patients, infected with hepatitis C virus (HCV) between 1961 and 1985.
The clinical and treatment records from 310 patients with inherited coagulation disorders were reviewed. All were treated with blood product before 1985. Standard survival analysis methods were used to model progression to liver failure and death.
98% of patients tested were anti-HCV positive. 9%, who were consistently HCV polymerase-chain-reaction-negative, were considered to have cleared the virus.
By 1 September 1999, 72% were alive, 8% had suffered a liver-related death, and 20% had died from other, predominantly HIV-related, causes.
Progression rates to death, 25 years after HCV exposure:
Any cause: 47%
25 years after HCV exposure, the Kaplan-Meier progression rate to death from any cause was 47%, but 19% from liver-related death.
For the 13 years from 1985, HIV-negative patients had progression rates to death from any cause and from liver-related causes of 8% and 3%, respectively. However, these progression rates were 57% and 21% for HIV-positive patients.
On behalf of the group, Professor Christine Lee concluded that, "The 25-year follow up has shown the potentially lethal combination of HIV and HCV co-infection. However, HCV singly infected individuals show slow progression of liver disease."