Doctors treating haemophilia were aware from 1984 that dry-heat-treated blood products were "valueless" in stopping patients becoming infected with hepatitis C, the Lindsay tribunal heard yesterday.
Prof Eric Preston, a haematologist from Sheffield, England, said it was clear from that date that vapour- and wet-heat-treated concentrates were better in terms of viral safety. As a result dry-heat-treated products were rapidly abandoned.
There remained, however, some uncertainty at the time as to what was the safest product, he said.
Between 1985 and 1987, he said, he used super-heat-treated National Health Service factor 8, which was safe from HIV and hepatitis C. But, because it was in limited supply, he had to use other products, including wet- and vapour-heated concentrates.
Dry-heat-treated products were considered as an option for the first couple of months in 1985 but then "discarded".
In contrast, the tribunal has heard, dry-heat-treated concentrates continued to be used in the Republic up to 1989 when virally-safe products made by solvent detergent technology became available on a phased basis.
During questioning by Ms Grainne Clohessy, for the tribunal, Prof Preston said non-A non-B hepatitis, as hepatitis C was known, was considered in the late 1970s as "a small price to pay" for the benefits of factor concentrates. He thought most individuals held the view that it was a relatively mild, although worrying, virus.
Views began to change in mid-1985 when he published a study in the Lancet showing that progressive liver disease was a "potentially serious problem" for haemophiliacs.
He wrote: "Although few reports of death attributable to liver disease in haemophilia have appeared, we predict that will become more common."
Despite the warning, he said "little attention" was paid to the problem at the time.
He noted the rate of progression to chronic acute hepatitis and cirrhosis was "substantially greater" in haemophiliacs, compared to other people infected with hepatitis C, due to the fact that they were exposed to multiple strains of the virus and a heavy viral load from continuous treatment.
Under cross-examination, Prof Preston confirmed a number of mild haemophiliacs in Sheffield were given concentrates in 1984 despite a recommendation the previous year that a synthetic drug DDAVP be "considered" instead. He did not think it would be inappropriate to use concentrates on mild haemophiliacs as cover for major surgery.
