Abstract
Infections caused inadvertently during clinical intervention provide valuable insight into the spectrum of human responses to viruses. Delivery of hepatitis C virus (HCV)-contaminated blood products in the 70s (before HCV was identified) have dramatically increased our understanding of the natural history of HCV infection and the role that host immunity plays in the outcome to viral infection. In Ireland, HCV-contaminated anti-D immunoglobulin (Ig) preparations were administered to approximately 1700 pregnant Irish rhesus-negative women in 1977–1979. Though tragic in nature, this outbreak (alongside a smaller episode in 1993) has provided unique insight into the host factors that influence outcomes after HCV exposure and the subsequent development of disease in an otherwise healthy female population. Despite exposure to highly infectious batches of anti-D, almost 600 of the HCV-exposed women have never shown any evidence of infection (remaining negative for both viral RNA and anti-HCV antibodies). Detailed analysis of these individuals may shed light on innate immune pathways that effectively block HCV infection and potentially inform us more generally about the mechanisms that contribute to viral resistance in human populations.
Highlights
Hepatitis C virus (HCV) is a human hepatotropic pathogen, transmitted via direct contact with infectious blood or blood-derived products [1]
These studies attempted to trace the recipients of HCV-positive blood donations and blood-derived products, screening all individuals who were potentially exposed to these products
This review explores the unique circumoccurred following the use of HCV-infected plasma from a single donor who had sympstances surrounding the 1977–1979 outbreak andinfection the subsequent research in toms or risk factors indicative of potential
Summary
Hepatitis C virus (HCV) is a human hepatotropic pathogen, transmitted via direct contact with infectious blood or blood-derived products [1]. With the development of diagnostic assays specific for HCV, several countries initiated large scale studies to identify and test individuals exposed to infectious viruses, such as HCV via contaminated blood donations or blood-derived products [7–9]. These studies attempted to trace the recipients of HCV-positive blood donations and blood-derived products, screening all individuals who were potentially exposed to these products In doing so, these studies identified a spectrum of outcomes following HCV exposure that ranged from those who resisted infection (exposed seronegative; ESN), spontaneous resolvers (SR) and those who became chronically infected (CI; Figure 1) [8]. This review explores the unique circumoccurred following the use of HCV-infected plasma from a single donor who had sympstances surrounding the 1977–1979 outbreak andinfection the subsequent research in toms or risk factors indicative of potential [12] This reviewundertaken explores the these exposed rhesus-negative women.
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