Hepatocellular failure from hepatitis C infection in two recipients of a single batch infusion of plasma-derived blood products

We report two patients with mild inherited bleeding disorders who acquired hepatitis C infection after receiving single infusion of plasma-derived concentrates prior to the introduction of donor screening and viral inactivation procedures. Both these patients became clinically jaundiced at the time of hepatitis C infection. Despite being HIV antibody negative, an absence of other risk factors of chronic liver disease and treatment with interferon, they progressed to hepatocellular failure in 5 and 12 years following seroconversion. The natural history of hepatitis C infection is still uncertain [1], although it is usually considered that hepatitis C infection progresses slowly, only resulting in clinically manifest liver disease after several decades. In view of the apparent rapidity of onset of liver damage in these two patients, we wonder if older age at time of infection, jaundice during the seroconversion illness or a mild coagulopathy with consequent infrequent exposure to blood products are adverse prognostic features.