LONG-TERM FOLLOW UP OF PATIENTS WITH SPONTANEOUS CLEARANCE OF HEPATITIS C

EASL; Session Title: Category 08b: Viral Hepatitis C: Clinical (except therapy)


Presentation Date: 02 APR, 2011

LONG-TERM FOLLOW UP OF PATIENTS WITH SPONTANEOUS CLEARANCE OF HEPATITIS C

M. Iqbal, R. Mac Nicholas*, C. Mcnulty, J. Hegarty, A. Mc Cormick

Liver Unit, St . Vincents University Hospital, Dublin, Ireland. *rossmacnicholas@gmail.com

Introduction: Irish anti-D cohort is a unique group of patients identified in 1994, who received contaminated anti-D immunoglobulin in 1977. A large number of women were found to be antibody positive but PCR negative means that they have spontaneously cleared the virus. Spontaneous clearance of hepatitis C occurs in 10 -25% of patients. Controversy remains whether spontaneous clearance of hepatitis C means complete cure of infection or ongoing infection despite negative PCR testing.

Background & aims: Almost 33 years after inoculation and 16 years after the diagnosis, a large number of women who spontaneously cleared the virus are still attending the liver unit at St Vincent's University Hospital. This gives us the opportunity to follow the natural course and outcome of this unique group of patients who remain PCR negative.The aims of this study is to see whether any of these PCR negative patients became PCR positive at any stage or is there any evidence of chronic liver disease or its complication over these years.

Method: This is a retrospective review of all the patients who were exposed to contaminated anti-D and have attended liver unit at St Vincent's University Hospital.

Results: A total of 118 patients were identified of these 45 were indeterminate on RIBA testing and rest were positive. All of these were PCR negative.52 (44%) patients have attended the outpatients in last three years. The mean follow up of these patients was 12 years (range 7-15). The mean age was 58 years. None of these patients were found to be PCR positive on serial testing .Liver function tests remain normal with mean ALT 22 .No evidence of chronic liver disease or its complication were found on clinical, biochemical and radiological examination. 66(56%) patients who were not seen in last three years have a mean follow up of 6 years (range 2-12). These women were also PCR negative on their last testing.

Conclusion: Women who were exposed to contaminated anti D almost 33 year ago and were PCR negative at initial testing remain PCR negative with no evidence of chronic liver disease or its complications.

http://www1.easl.eu/easl2011/program/Posters/Abstract1042.htm