Coinfection with HIV is common and will demand great resources

The haemophilic community in Britain, already hit by HIV infection, is now facing the problem of chronic hepatitis C. The high incidence of hepatitis after treatment with clotting factor concentrate from a large pool was first identified by Kasper and Kipnis in 1972.1 They found that infection was more common in young patients having their first treatment. It is now known that there was virtually a 100% rate of transmission of hepatitis C virus to previously untreated patients with haemophilia until effective procedures to inactivate the virus were introduced in 1985-6.2 3 Transmission of hepatitis C occurred with plasma from NHS and commercial sources. Studies of the hepatitis C virus genotype found in British patients with haemophilia who have been treated with concentrates have shown types 1, 2, and 3, reflecting contamination from the British and North American donor pool. Type 4 (reported in the Middle East and Zaire) and type 5 (reported in South Africa) have also, however, been found in a few patients, leading to speculation about the source of some commercial concentrates.4 …