Morbidity and mortality in paid Austrian plasma donors infected with hepatitis C at plasma donation in the 1970s

Background/Aims Between 1964 and 1987 several epidemic outbreaks of hepatitis C virus infection linked to plasma donation occurred at plasmapheresis centres in Austria. Data collected by a Foundation to help the victims enabled us to study the natural history of chronic hepatitis C in this cohort. Methods Medical records and charts of donors accepted by the Foundation were analyzed. Results Four hundred and eighty-five subjects (439 males; mean age at infection: 22 years) were included. Mean follow-up was 31 years. Thirty-four percent of plasma donors had advanced liver disease; alcohol abuse and diabetes were related to progression. Twenty-one patients developed hepatocellular carcinoma; 36 underwent liver transplantation. Six donors cleared the virus spontaneously. Forty died, with death directly related to liver disease in 25 donors. Overall and transplant-free 35-year cumulative survival rates were 84% and 74%, respectively. Three hundred and nineteen patients received and 291 completed antiviral treatment. All 56 who achieved a sustained virologic response are alive and well; 14 non-responders died and nine underwent liver transplantation. Conclusions Thirty-one years after virus infection, advanced liver disease has developed in a third of patients, with an overall mortality of 7%. These data underline the progressive nature of chronic hepatitis C infection and the need to identify and treat infected subjects.