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Hepatitis C virus infection in hypogammaglobulinemic patients receiving long‐term replacement therapy with intravenous immunoglobulin
Author(s) -
Taliani G.,
Guerra E.,
Rosso R.,
Badolato M. C.,
Luzi G.,
Sacco G.,
Lecce R.,
Bac C.,
Aiuti F.
Publication year - 1995
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1995.35295125730.x
Subject(s) - medicine , seroconversion , viremia , hepatitis c virus , antibody , gastroenterology , hepatitis c , alanine transaminase , immunology , virus
BACKGROUND: Hepatitis C virus (HCV) seroconversion and viremia have been reported in patients treated with intravenous immunoglobulin (IVIG). STUDY DESIGN AND METHODS: A prevalence study was conducted to evaluate the rate of HCV infection in patients undergoing long‐term treatment with IVIG. Fifty‐four patients with congenital or acquired hypogammaglobulinemia treated with IVIG at 300 to 400 mg per kg every 14 to 21 days for a mean of 6.6 years were enrolled for clinical and biochemical examination. The type of IVIG preparation (type 1 only, type 2 only, or other products) administered to each patient was recorded. Antibodies to HCV were measured by enzyme‐linked immunosorbent assay and immunoblotting; HCV RNA was detected by nested polymerase chain reaction. RESULTS: Anti‐HCV was detected in 31 patients (57.4%) and HCV RNA was found in 5 patients (9.2%), all of whom were anti‐HCV‐positive. Abnormal alanine aminotransferase (ALT) levels were found in 10 patients (18.5%). Circulating HCV RNA (p = 0.01) and elevated ALT (p = 0.01) correlated significantly with anti‐ HCV positivity. Moreover, the rates of anti‐HCV positivity and of ALT elevation were significantly higher among patients treated with type 1 IVIG and other products than among those receiving type 2 IVIG (p < 0.001 and p = 0.05, respectively). CONCLUSION: Anti‐HCV positivity and viremia were frequently observed. The significant correlation between the detection of HCV RNA, the elevation of ALT, and positivity for anti‐ HCV suggests HCV infection. Exclusion of anti‐HCV‐positive donors and of anti‐HCV‐positive IVIG lots should improve the safety of IVIG.