Assessment of long-term outcomes of hepatitis C virus infection in a cohort of patients with acute hepatitis in 1971-1975: Results of a pilot study

Background: To examine the long-term effects of hepatitis C virus (HCV) inf ection in a cohort of patients admitted to Fairfield Hospital with hepatiti s from 1971 to 1975. The availability of stored sera from this time enabled testing to identify those who were anti-HCV positive on admission. Methods: Sixteen per cent (n = 230) of the cohort tested positive for HCV a ntibody (anti-HCV). The 'unexposed' group was selected from those who were anti-HCV negative. Systematic approaches were used to locate the cohort and health outcomes assessed by a study specific questionnaire and clinical re view with repeat serology and liver function tests. Results: Complete follow up has been achieved on a subset of 35 HCV-seropos itive and 70 seronegative individuals. The seropositive group was significa ntly more likely to have given a history of injecting drug use, the presume d route of infection. The seropositive group was also more likely to have e levated serum alanine aminotransferase levels, but only two (6%) were known to have progressed to cirrhosis. Discussion: The anti-HCV-positive individuals followed up to date are at in creased risk of liver-related pathology, bur few had progressed to cirrhoti c liver disease. This differs from findings of transfusion-related studies and suggests, within the limitations of the study, chat the natural history of community acquired HCV may be more benign.