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An extract from Hospital Week by the American Hospital Association noted that President Nixon had called for a study to improve the blood collection and distribution system that relied on commercial blood banks. Previous studies proved that blood transfusions had caused 30,000 hepatitis infections every year. The risk of hepatitis from commercial blood supply was acknowledged.

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Together with other authors, Professor Garrott Allen concluded in an article titled "Blood Transfusions and Serum Hepatitis" published in Annals of Surgery, that those who received blood from paid donors had a rate of hepatitis infection of 7 to 10 times greater than seen in those who had had volunteer blood.

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Professor Garrott Allen warned in an article titled "Post-Transfusion Hepatitis: A Serious Clinical Problem" published in California Medicine April 1966 that: "The risk of serum hepatitis from transfusions derived from prison and Skid row populations is at least 10 times that from the use of volunteer donors."

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Dr Harvey Alter and others wrote an article titled "The Ausria Test: Critical Evaluation of Sensitivity and Specificity" in Blood December 1973 in which it was observed: "By far, the single most significant measure for the reduction of posttransfusion hepatitis is the total exclusion of the commercial donor."

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Dr Manucci and others wrote an article titled "Asymptomatic liver disease in haemophiliacs" published in the Journal of Clinical Pathology in 1975 which observed liver disease in people with haemophilia and concluded "that repeated and prolonged contact with the infective agent(s) may cause chronic liver damage not associated with overt illness".

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Professor Arie Zuckerman wrote an article titled "Developments in Viral Hepatitis" published in the Journal of Medical Virology in 1978. He reviewed earlier studies and noted that cases of non-A non-B Hepatitis were commonly reported as a cause of persistent liver damage. He summarised: "it seems that this infection may progress to chronic liver disease."

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Dr Berman and others wrote an article titled "The Chronic Sequelae of Non-A Non-B Hepatitis" published in the Annals of Internal Medicine July 1979, which described the progression of non-A non-B Hepatitis to cirrhosis over time.

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The Medical Research Council wrote a letter regarding an ad hoc meeting on non-A non-B Hepatitis to discuss the seriousness of the infection, and the need for research and studies to identify non-A non-B Hepatitis and develop a test. Middlesex Hospital Medical School then wrote to the DHSS noting that non-A non-B Hepatitis might be a problem for people who did not have haemophilia, but had received a transfusion and that it would be logical to co-opt any studies with PHLS.

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Dr Mark Winter said in oral evidence that Dr Preston's 1978 paper about liver disease in people with haemophilia in The Lancet "blew out of the water instantly the idea that this [non-A non-B Hepatitis] was nothing to worry about because their study showed, as did other studies, that most of these patients had very significant chronic liver disease".

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Alexander Macpherson said he had not thought to question the risk that blood products might cause hepatitis amongst his pupils because it was well known when he first came to the school.

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Dr George Grady and others wrote that Hepatitis B antigen accounted for around 60% of the cases of post-transfusion hepatitis.

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Mirick et al noted that blood from prison and skid row populations was at least 10 times that from volunteer donors.

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Professor Garrott Allen returned to the theme in several following publications that transfusions derived from prison and Skid row populations was at least 10 times that from the use of volunteer donors.

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Professor Garrott Allen noted that approximately 0.9% of total transfused patients would suffer disability or death due to transfusion hepatitis.

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Matthew Hill

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The Report of the Advisory Group on Testing for the Presence of Australia (Hepatitis-Associated) Antigen and its Antibody reported that although the hepatitis agent may be less widely found in the UK, the testing of donations for the Australia antigen should reduce the incidence of serum hepatitis to avoid suffering and disablement and death.

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Mr Gidden wrote to the secretaries of regional hospital boards to suggest testing donations for the Australia antigen should reduce the incidence of serum hepatitis to avoid suffering and disablement and even death.

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Regional transfusion centres highlighted that blood screening did not occur across the board in respect of whole blood until 1972.

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Dr John Craske and Dr Peter Kirk published a report stating that further research was required to assess the incidence of chronic liver disease after non-B Hepatitis.

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Dr Vivian Mitchell noted that for at least some haemophilia patients treated with factor concentrates chronic liver disease could be progressive.

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