Intravenous immunoglobulin prophylaxis causing liver damage in 16 of 77 patients with hypogammaglobulinemia or IgG subclass deficiency

Low frequency of cirrhosis in a hepatitis C (genotype 1b) single-source outbreak in germany: A 20-year multicenter study

“…For instance, higher rates of chronic infection and poorer outcomes than with the HCV genotype 1b infection in our study have been observed after transmission by a similar route, i.e., HCV-contaminated immune globulin, in young adults with hypogammaglobulinemia. 34,35 Transmission by blood transfusion also appears to be associated with a poorer outcome of hepatitis C in adults [20][21][22][23][24][25][26]29 related maybe to a larger size viral inoculum and the often impaired immune status by major surgery and comorbidity. By contrast, chronic HCV infection in asymptomatic blood donors had rates of less than 10% severe morbidity during the first 2 decades.…”

Hepatitis C viral infection in the immunosuppressed patient

“…In a further study of non-A, non-B hepatitis in patients with hypogammaglobulinaemia who received hepatitis C infected immunoglobulin G, 3 of 12 (25%) developed cirrhosis within 5 years of infection. 6 In immunocompetent subjects, factors recognized as associated with more progressive hepatitis C, namely in males, the onset of infection Ͼ40 years and alcohol intake Ͼ50 g/day 7 were not relevant in these studies of hypogammaglobulinaemic patients infected with hepatitis C. 3,4 While initial infecting viral load may be important, 8 other viral factors, such as HCV quasispecies, have not been studied in these patients.…”

“…Most patients with hypogammaglobulinaemia who are also infected with HCV acquired their infection from batched contaminated immunoglobulin [2][3][4][5] and were already immune incompetent at the time of infection. These include individuals with isolated immunoglobulin deficiencies and combined immunodeficiency syndromes.…”

“…Symptomatic hepatitis with icterus was observed in 25%. 3,5 Histologically proven chronic hepatitis developed in 75% 3,4 and the rate of progression to cirrhosis was high (31%). 3 This high rate of progression to cirrhosis was confirmed by a Swedish study.…”

“…3,5 Histologically proven chronic hepatitis developed in 75% 3,4 and the rate of progression to cirrhosis was high (31%). 3 This high rate of progression to cirrhosis was confirmed by a Swedish study. Six of 17 (35%) infected patients were reported as cirrhotic within 10 years of infection, two of whom developed liver failure 4 within this time period.…”