Garvey P, et al. – In the mid–1990s, a group of Rh negative women was diagnosed with hepatitis C virus (HCV) genotype 1b infection following administration of contaminated anti–D immunoglobulin in 1977–79. In this paper, authors sought to describe their disease history and estimate the effect of selected host and treatment factors on disease progression. There appeared an acceleration in development of liver–related outcomes with time, with the risk of cirrhosis, hepatocellular carcinoma, and liver–related death doubling in the latest five years of follow–up, particularly in women with high alcohol consumption and diabetes mellitus. Researchers recommended advising patients with chronic HCV infection of the additive harmful effect of high alcohol consumption.

Methods

• A cohort study was performed on the women infected with HCV.
• Information regarding demographics, treatment and health outcomes up to 31st December 2013 was collected from records at seven HCV treatment centres.
• Calculation of cumulative incidence, case fatality, and sub hazard ratios (SHR) for disease progression was performed using competing risks regression.

Results

• This study included 682 participants.
• 374 chronically infected participants were identified; 35% completed interferon–based antiviral treatment; 42% of whom had a sustained virological response.
• At the end of 2013, cirrhosis, hepatocellular carcinoma, and liver–related death were observed in 19%, 1.9%, and 4.9% of chronically infected participants, respectively, compared with 10%, 0.8%, and 2.4% at the end of 2008.
• At the end of 2013, 321 (86%) of chronically infected participants remained alive; chronic infection was evident in 247 (77%) of these patients.
• Increased cirrhosis rates seemed associated with factors such as high alcohol intake (aSHR=4.9 (2.5–9.5)) and diabetes mellitus (aSHR=5.0 (2.9–8.8)).