The ‘chilling cover-up’ of the U.K.’s infected blood scandal

Sub: Science and tech

Sec: Health

Context:

The Infectious Blood Inquiry led by former judge Brian Langstaff catalogs preventable failures by doctors and successive governments that led to decades-long treatment disasters in the U.K.

About the scandal:

Between the 1970s and 1990s, more than 30,000 people were infected with HIV, Hepatitis C and Hepatitis B after receiving contaminated blood and blood products imported from the U.S.
This made it the “worst treatment disaster” in the history of Britain’s state-funded National Health Service (NHS).

Key highlightings of the investigation:

The public inquiry in the UK was commissioned in 2017 to examine the circumstances in which men, women, and children were treated by National Health Services.
The blood scandal revealed failures at an individual, collective and systemic level.
The affected included two groups: those with hemophilia (and similar blood disorders), and people who received blood transfusions during surgeries and childbirth.
At least 3,000 people have died due to receiving infected blood.
Deaths and infections linked to contaminated blood were also recorded in Australia, Canada, China, France, Ireland, Italy, Japan, Portugal, and the U.S.

What is Haemophilia?

Hemophilia is a rare disorder in which the blood doesn’t clot in the typical way because it doesn’t have enough blood-clotting proteins (clotting factors).
This results in people bleeding for a longer time after an injury, easy bruising, and an increased risk of bleeding inside joints or the brain.

There are two main types of hemophilia:

Hemophilia A, which occurs due to low amounts of clotting factor VIII, and
Haemophilia B, which occurs due to low levels of clotting factor IX.
They are typically inherited from one’s parents through an X chromosome carrying a nonfunctional gene.
Most commonly found in men, hemophilia can affect women too, though very rarely.
A woman would need to inherit two affected X chromosomes to be affected, whereas a man would only need one X chromosome affected.
Haemophilia C, which occurs due to low levels of factor XI, Von Willebrand disease, which occurs due to low levels of a substance called von Willebrand factor, and parahemophilia, which occurs due to low levels of factor V

Treatment:

Up until the 1970s, treatment options included administering the frozen blood product cryoprecipitate. It carried a low risk of passing on an infection since it was formulated from a single blood donation, but cryo was hard to store and harder to administer to patients.
Enter Factor VIII, a revolutionary ‘wonder treatment’ made using concentrating pooled plasma from tens of thousands of donors.
Factor VIII had a high risk of infection.
Even one blood sample, if infected with HIV or Hepatitis C, could contaminate the entire batch.

Other Blood related infections:

The agent for Hepatitis C was identified in 1988, and the first case of AIDS in the U.K. was recorded in 1981.
Research as early as the 1940s shows transfusions or the use of plasma could transmit “serum hepatitis,” which could be fatal or lead to long-term diseases such as liver failure and cancer.

About Hepatitis:

Hepatitis is an inflammation of the liver that can be caused by various infectious viruses and non-infectious agents, leading to potentially fatal health issues.
There are five main types of the hepatitis virus—A, B, C, D, and E.
Each type causes liver disease but varies in transmission modes, illness severity, and geographic prevalence.
Types B and C are particularly significant as they often lead to chronic conditions and are the major causes of liver cirrhosis, liver cancer, and deaths related to viral hepatitis.
There is no vaccine for hepatitis C.
Patients with the hepatitis C virus can recover completely.
Hepatitis B is dangerous because it is a “silent infection,” which means it can infect people without them knowing it.

About HIV:

HIV attacks CD4, a type of White Blood Cell (T cells)in the body’s immune system.
T cells are those cells that move around the body detecting anomalies and infections in cells.
After entering the body, HIV multiplies itself and destroys CD4 cells, thus severely damaging the human immune system. Once this virus enters the body, it can never be removed.
The CD4 count of a person infected with HIV reduces significantly. In a healthy body, CD4 count is between 500- 1600, but in an infected body, it can go as low as 200.
Weak immune system makes a person prone to opportunistic infections and cancer. It becomes difficult for a person infected with this virus to recover from even a minor injury or sickness.
HIV can be treated and prevented with antiretroviral therapy (ART).
Untreated HIV can progress to AIDS, often after many years.