Outcome of intravenous immunoglobulin-transmitted hepatitis C virus infection in primary immunodeficiency.
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.
Razvi
S
S
The Department of Medicine, Mount Sinai School of Medicine, New York City, New York 10029, USA.
Schneider
L
L
Jonas
M M
MM
Cunningham-Rundles
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D004340:Drug Contamination; D006526:Hepatitis C / Q000188:drug therapy* / Q000635:transmission*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects* / Q000627:therapeutic use; D007153:Immunologic Deficiency Syndromes / Q000188:drug therapy*; D016898:Interferon-alpha / Q000627:therapeutic use*; D008875:Middle Aged; D012254:Ribavirin / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D016898:Interferon-alpha; D012254:Ribavirin