Outcome of intravenous immunoglobulin-transmitted hepatitis C virus infection in primary immunodeficiency

Clin Immunol. 2001 Dec;101(3):284-8. doi: 10.1006/clim.2001.5132.

Abstract

Physicians in the United States who treat patients with primary immunodeficiency were contacted to identify subjects who had been infected with hepatitis C due to exposure to contaminated intravenous immunoglobulin (IVIg) in 1993-1994. From this survey we gathered information on 58 PCR-positive hepatitis C-infected patients; 37 had CVID, 9 had XLA, 5 were IgG subclass deficient, 4 were antibody deficient with normal immunoglobulin levels, 2 had SCID after BMT, and 1 had B cell linker deficiency. Of the 58 subjects, 30 had been treated with IFN-alpha in combination with ribavirin in 5 cases, and 26 other subjects were not treated. Of those who were treated, 11 (37%) resolved the infection and became PCR-negative; of the 26 who were not treated, 5 (19%) have resolved the infection, outcomes not significantly different. Patients 20 years of age or younger had a significantly better outcome compared to those older than age 20 (P = 0.02). Five subjects of the 58 have had a liver transplantation, a sixth has had two transplants, and 10 (17%) of the group have died. This survey demonstrates the heterogeneity of the clinical outcome in subjects with primary immunodeficiency who contracted hepatitis C due to viral contamination of IVIg.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use*
  • Child
  • Drug Contamination
  • Hepatitis C / drug therapy*
  • Hepatitis C / transmission*
  • Humans
  • Immunoglobulins, Intravenous / adverse effects*
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Deficiency Syndromes / drug therapy*
  • Interferon-alpha / therapeutic use*
  • Middle Aged
  • Ribavirin / therapeutic use*
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Immunoglobulins, Intravenous
  • Interferon-alpha
  • Ribavirin