National Responses to HIV Versus HCV-Infection from Virally Contaminated Blood Products among Persons with Hemophilia (PWH): More Different Than Alike.

Abstract

Background: 95% of HIV- and HCV-infections among PWHs occurred with use of contaminated blood products prior to 1985. Overall, 20% to 90% of PWHs in developed countries have HIV- and/or HCV-infection. We compared country-specific public health approaches, judicial activities, and compensation for these viral infections.Methods: Reports from hemophilia organizations, national ministries of health, published articles, and the World Federation of Hemophilia were reviewed.Results: Except for the United States, the number of PWHs who developed HCV-infection from contaminated blood products was 1.5 to 3-fold as great as for HIV-infection- as a result of delayed use of heat-treated blood products, importation in late 1984 of HCV-infected non-heat treated blood products from the United States, and failure to use surrogate laboratory marker hepatitis screening tests. Compensation funds for HIV-infected PWHs were established in Japan ($521,000 at Dx); France ($305,000 at Dx; $102,000 for AIDS); the United States ($115,000 at Dx); Ireland ($106,000 at Dx); the United Kingdom ($55,000 at Dx); Australia ($48,000 at Dx); Canada ($13,000 at Dx/$18,000/yr); Germany ($12,000/yr for HIV; $24,000/yr for AIDS); and Italy ($6,000/yr; $82,000 at death). Compensation has also been provided to HCV-infected PWHs in Ireland ($266,000 at Dx); Canada ($251,000 at Dx); the United Kingdom ($33,000 at Dx; $42,000 if w/liver damage); and Italy ($10,000/yr; $37,000 at death).Conclusions: In most developed countries, despite a greater number of HCV-versus HIV-infected PWHs, markedly less attention has been paid to HCV-infected PWHs. All countries should review HCV-related blood safety decisions made in the 1980s and consider providing compensation to HCV-infected PWHs.A comparison of national responses to HIV and HCV infections from blood productsCountry -PWH (thousands)% PWH with HIV:HCVMan-dated HIV ELISA (date)Man-dated heat Rx factor (date)Anti-HBc marker screening (date)Nat'l Funds for HIV/HCV among PWHs (year)Nat'l Panels for HIV/HCV decisions (year)USA-2050%:30%Mar 85Oct 84Oct 8496/none95/noneItaly- 8.723%:55%Mar 85Jul 85None92/9892/05GDR- 647%:90%Oct 85Oct 85None95/none94/noneUK-628%:80%Oct 85Jun 85None88/0387/05France-450%:90%Aug 85Oct 85None89/none91/noneJapan-3.460%:90%Nov 86Jun 86None88/none96/noneCanada-240%:88%Nov 85Jul 85None89/9897/noneAustralia-1.531%:90%May 85Jan 85None89/none88/noneIreland-0.336%:76%Oct 85Feb 85None91/9791/97