PROGRESS OF LIVER DISEASE IN HEPATITIS C VIRUS CARRIERS FOUND AT THE BLOOD DONATION AND ITS OUTCOMES: 18-YEAR COHORT STUDY ON 1021 CARRIERS

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


Presentation Date: 02 APR, 2011

EASL; PROGRESS OF LIVER DISEASE IN HEPATITIS C VIRUS CARRIERS FOUND AT THE BLOOD DONATION AND ITS OUTCOMES: 18-YEAR COHORT STUDY ON 1021 CARRIERS

J. Matsuo1*, H. Okita2, M. Mizui2, K. Katayama1, A. Tabuchi1, T. Akita1, A. Nakashima1, J. Tanaka1, Hiroshima Hepatitis Study Group

1Department of Epidemiology, Infectious Disease Control and Prevention, Hiroshima University, 2Department of Laboratory Medicine, Japanese Red Cross, Hiroshima, Japan. *matsujunn@hiroshima-u.ac.jp

Background/aim: “Asymptomatic” is a main characteristic of Hepatitis C virus (HCV) infection and it has been an important problem at blood donation. Many studies show HCV prevalence among blood donors without physical symptoms. This study is aimed to show what is the natural course and outcomes in asymptomatic HCV carriers= (ASC) found at the blood donations by 18-year cohort study.

Methods: 3,377 HCV positive blood donors from 1991 to 2003 were suggested to consult hepatologists. We followed clinical course and treatment effect of 1,021 cases who came to the hospitals under cooperation of Hiroshima Hepatitis study group. The Ethic Committees of Hiroshima University approved the study.

Results: The mean age was 45.3±11.4, mean observed period was 7.1±6.64 years and the longest observed period was 18.4 years. At the first clinical consultation, chronic hepatitis (CH) was diagnosed among 531(53%) cases, liver cirrhosis (LC) in 5(0.5%) and Hepatocellular carcinoma (HCC) in 1 (0.1%). Liver disease progressed in ASC and 15-year cumulative incidence rate of CH from ASC is 74%(Fig. 1).

[incidence]

166/396(41.9%) were sustained viral responder (SVR) with IFN treatment. Without IFN treatment, in 4 cases, HCVRNA disappeared spontaneously. Natural disappearance rate of HCVRNA is 1.5/1000 person-year without IFN (n=600). The cumulative incidence rates of HCC were similar in groups with or without IFN treatment in Kaplan-Meyer's survival analysis. In multivariate analysis with Cox Hazard Model for HCC incidence by sex, initial age, initial diagnosis and with or without IFN treatment, the risk was significantly high in the older and the CH patients diagnosed at the first examimation (Tab.1).

 

 [tab1]


Conclusion: Amazingly over 50% of HCV positive donors had got liver disease already although they had thought themselves healthy enough. We emphasize that HCV positive blood donors are not actulal ASC anymore. Finding earlier stage liver disease in “Asymptomatic” HCV carriers is needed to prevent HCC. Moreover we showed ASC progress into CH with high rate, and consequently continuous follow-up for ASC is indispensable.




http://www1.easl.eu/easl2011/program/Posters/Abstract1043.htm