A multidisciplinary team from the USA investigated mortality and morbidity rates in people with non-A, non-B hepatitis after 25 years' follow-up.
Data was obtained from three transfusion studies with archived original sera, conducted in the early 1970s. Cases were compared for outcome with matched, transfused, non-hepatitis controls from the same studies.
The researchers, who worked in collaboration with the National Heart, Lung, and Blood Institute, found that all-cause mortality was 67% among 222 hepatitis C-related cases and 65% among 377 controls, after 25 years. Liver-related mortality was 4.1% and 1.3%, respectively.
Of 129 living people with previously diagnosed transfusion-associated hepatitis (TAH), 70% had proven TAH-C, and 30% had non-A-G hepatitis.
Follow-up of the 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%.
|Incidence of all-cause mortality and liver-related mortality after 25-year follow-up:|
Hepatitis C-related cases:
67% and 4.1%
65% and 1.3%
20 TAH-C patients were biopsied for biochemically defined chronic hepatitis.
35% displayed cirrhosis, representing 17% of all those originally HCV-infected, the researchers found.
Clinically evident liver disease was observed in 86% with cirrhosis, but in only 23% with chronic hepatitis alone.
30% of non-A, non-B hepatitis cases were unrelated to hepatitis viruses A, B, C, and G, suggesting another unidentified agent, the researchers commented.
Dr Leonard B. Seeff said on behalf of the group, "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," he concluded.