Rapidly progressive hepatitis C in a patient with common variable immunodeficiency.
A 15-year-old girl with common variable immunodeficiency contracted hepatitis C, which progressed to liver cirrhosis and finally to hepatic failure 5 years later. Since she was agammaglobulinaemic, hepatitis C virus (HCV) infection was diagnosed on the basis of HCV-RNA detection. Quantification of her sera showed high levels of HCV-RNA (more than 10(7) copies of RNA/mL), which implied active viral replication. There were no other hepatotoxic factors except HCV infection. The initial liver biopsy at 16 years of age and the autopsy confirmed a rapid progression in liver histopathological change over 4 years.


CONCLUSIONS
Contrary to the widely held view of a benign short-term prognosis in paediatric hepatitis C, progressive fatal liver disease can develop in some patients with HCV infection. Such a rapid progression of liver injury provides the rationale for antiviral therapy in at least certain high risk groups of these children. Hepatitis C may progress rapidly in an immune deficiency condition.
Sumazaki
R
R
Department of Paediatrics, University of Tsukuba, Ibaraki, Japan.
Matsubara
T
T
Aoki
T
T
Nagai
Y
Y
Shibasaki
M
M
Takita
H
H
D000293:Adolescent; D017074:Common Variable Immunodeficiency / Q000150:complications* / Q000276:immunology; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000473:pathology; D017093:Liver Failure / Q000209:etiology / Q000473:pathology; D012367:RNA, Viral / Q000032:analysis
D012367:RNA, Viral