Abstract
Sixteen of 62 patients with acute liver failure (44 patients with acute-type fulminant hepatitis, 13 with subacute-type fulminant hepatitis and 5 with subacute hepatitis) in our department from 1977 to October 1989, before hepatitis C virus (HCV)-associated antibodies tests were developed, survived (survival rate: 26%). In the 14 patients who underwent long-term follow-up study (11 with acute-type fulminant hepatitis, 1 with subacute-type fulminant hepatitis and 2 with subacute hepatitis), we performed various liver function tests, assayed HCV markers, and investigated whether liver dysfunction was still present. The follow-up periods after the onset ranged from 3 years to 15 years, and the average follow-up interval was 9.1 years. Current testing for HCV antibody was positive in a high proportion of the patients (71%, 10/14), and HCV-RNA was positive in 70% (7/10) of the 10 HCV antibody-positive patients. Chronic liver disease (CLD) was found to be present in 64% (9/14), and in 8 of the 9 attributed to infection by HCV. We also investigated the relationship between HCV infection and total amount of blood transfused. HCV antibody was positive in a high percentage of the 10 patients transfused with more than 3, 500ml of blood (90%, 9/10), but positive in only one of the 4 patients transfused less than 3, 500ml (25%). Our findings suggest that the HCV infection was in proportion to the total amount of blood transfused. Thus, among the survivors who received therapy for acute liver failure before October 1989, chronic liver disease was often found during long-term follow-up. These results suggest that HCV infection via blood transfusion may play an important role in the etiology of liver injury.
