Blood donor may sue over liver disease

CELIA HALL

Medical Editor

A blood donor who believes he caught the liver disease hepatitis C from his wife may sue his blood donation centre for giving poor advice. The couple say they were assured that the virus could not be transmitted by sexual intercourse.

The couple, from Southend, Essex, were both blood donors. The woman was given a positive diagnosis for hepatitis C virus (HCV) when blood centres began to screen donations in 1991.

In April this year, the husband, who had continued to donate, learnt that he too was positive for HCV.

"I am not a drug addict, I do not use needles and I have never had a blood transfusion. We were told we did not have to take precautions but there is no other way I could have got it," he said.

"I believe they were negligent in the advice they gave us and I have contacted my solicitor."

In a letter to him, the patient's consultant accepts his belief that "there is no other way" that he could have caught the virus. However, the consultant adds that sexual transmission is very rare.

The man is also concerned that he has not been prescribed the only drug available for hepatitis C, interferon alfa, which his wife has been given.

It is likely that his wife became infected when she had a blood transfusion in 1988 during a Caesarean operation. Until 1991, when all donations were routinely tested, doctors estimate that 1 in 2,000 donations was infected.

The Department of Health says that about 6,000 people who received whole blood were infected as a result of HCV in the blood supply, half of whom are still alive.

As a result, it is in the middle of a "lookback" exercise to trace these former patients. The first of these 3,000 people have been identified and liver and hepatitis support groups say they are "starting to trickle through" their doors.

A spokeswoman for the National Blood Authority said they had changed their advice on protected sex and hepatitis C as more information had become available.

"Initially we advised that people used condoms, even though the risk is low. But with more knowledge we thought that this approach was conservative and restricting. Then we decided to give people all the information and to leave it to individuals to make up their own minds," she said.

Alison Rogers, director of the British Liver Trust, said yesterday that there was a need for coherent national guidelines for testing the progress of disease in patients, for prescribing and for giving them advice about their lifestyle.

"We know of the Southend case and have already raised it informally with the Department of Health. We are now writing to the Department about the information given to patients.

"Hepatitis C is a very big issue. Patients need maximum information," she said.

The American Gastroenterological Association issued a statement in May recommending early and longer treatment of HCV-positive patients with interferon. There is no such agreement in the UK.

Hepatitis C is a "silent" disease which may not produce symptoms for 20 years. Without treatment, 25 to 50 per cent of patients will develop scarring of the liver and a proportion of those will have liver failure and some will develop liver cancer.

Interferon, which can give patients flu-like side effects, is effective in about half of patients but some will need to take it for long periods. One estimate is that it could cost the NHS pounds 300m to treat all HCV patients for six months.