Doctors treating haemophilia patients at an Edinburgh hospital around 1985 were more concerned about whether blood products might transmit HIV than hepatitis, an inquiry has heard.
The Infected Blood Inquiry was told a blood product available called NY was heat-treated, which was believed to inactivate HIV but not non-A, non-B hepatitis.
Thousands of patients across the UK were infected with HIV and hepatitis C – which was previously known as non-A, non-B hepatitis – through contaminated blood products in the 1970s and 1980s.
About 2,400 people died in what has been labelled the worst treatment disaster in the history of the NHS.
Professor Christopher Ludlam, consultant haematologist and reference centre director at the Royal Infirmary of Edinburgh from 1980 to 2011, continued giving evidence to the UK-wide inquiry remotely on Friday.
Jenni Richards QC asked him whether there was a need for a system to be put in place at the Royal Infirmary and other hospitals at the time to ensure patients with mild haemophilia did not receive NY unless absolutely necessary.
He replied: “A patient with mild haemophilia or a child with haemophilia who had a significant or serious bleed might still require treatment with clotting factor concentrate.
“At this time and over the following year or two, our chief concern was the possibility that blood products might transmit HIV, that was the really important thing.
“We were very keen indeed to try and avoid HIV transmission because of the consequences of it, and that in our minds became more important I think than the issue of non A, non B hepatitis, our first aim was to try and avoid HIV transmission.”
The inquiry also heard that in the summer of 1986, a young haemophiliac patient developed non A, non B hepatitis after receiving a heat-treated product.
Prof Ludlam said he had not been informed initially about the patient and he was “upset” and “disappointed” when he did hear about it.
He agreed this case was the “trigger” which prompted him to source some of a product called 8Y from England, which was still being studied but the information available suggested it was less likely to transmit hepatitis C.
Prof Ludlam denied his “investigative ambitions” drove the treatment policy as he continued to use blood products to treat patients in 1983 after it emerged in 1982 that Aids might be caused by a transmissible virus.
He said it was very important to monitor the immune status of the patients.
Ms Richards said a witness statement he gave “appears to suggest that a reason for continuing to use factor concentrates was your wish to be able to monitor immune status”.
She asked: “Did your research or investigative ambitions drive the treatment policy?”
Prof Ludlam replied: “No. Treatment decisions were driven by what seemed to be best for the patient.
“If what seemed to be best for the patient was the use of clotting factor concentrates, then that should be monitored, as we were doing for all the other monitoring investigations. It was not the other way around.”
We have now returned from our mid morning break.
Jenni Richards is asking Professor Ludlam about Hepatitis C testing in the early 90s.
Prior to its discovery in 1989, Hepatitis C had been known as non-A non-B hepatitis. pic.twitter.com/33zQffhYHw
— Infected Blood Inquiry (@bloodinquiry) December 4, 2020
The inquiry heard some patients gave blood samples for use in Prof Ludlam’s research but were not always told what they would be used for.
Asked whether he thought it was right in terms of consent for samples to be used for whatever research purpose or testing he chose, he said: “It certainly would not be nowadays. But I like to think our patients were pretty much in touch with what our research interests were.”
The inquiry heard blood from some haemophiliac patients at the centre was used in 1983 for research known as the Aids study, which he and a doctor at the Western General Hospital in Edinburgh launched after reports of Aids in people with haemophilia in the US.
However patients were not advised of the results of the analysis.
Ms Richards also asked why he did not seek or obtain ethical approval for the study, to which Prof Ludlam replied: “I considered them to be part of what we should be doing in monitoring the health of our patients.”
The inquiry before chairman Sir Brian Langstaff continues.