02954nas a2200205   4500008004100000020001400041024001700055245012400072210006900196260034900265300001600614490000800630520197100638100002002609700001802629700001702647700001802664700002102682856004502703       1994                        eng d  a0028-4793  a0255562, now00aHepatitis C Infection In Patients With Primary Hypogammaglobulinemia After Treatment With Contaminated Immune Globulin.0 aHepatitis C Infection In Patients With Primary Hypogammaglobulin  aOwned, published, and (C) copyrighted, 1994, by the MASSACHUSETTS MEDICAL SOCIETYbFrom the Section of Clinical Immunology and Infectious Diseases (K.B., S.S.F.) and the Section of Hepatology and Gastroenterology (K.B.), Medical Department A, and the Department of Pathology (T.H.), National Hospital, Oslo, Norway; the Department of Viroc1994  a1607 - 16110 v3313 aBackground: In Scandinavia many patients with primary hypogammaglobulinemia contracted non-A, non-B hepatitis after intravenous treatment with an immune globulin product that was later found to contain a non-A, non-B hepatitis virus., Methods: We studied the prevalence and clinical course of hepatitis C virus (HCV) infection in a group of 55 Norwegian patients with primary hypogammaglobulinemia and investigated its association with the use of contaminated immune globulin. We used the polymerase chain reaction to detect HCV RNA and performed HCV genotyping. We also analyzed the responses to treatment with interferon., Results: Of 20 patients who received the contaminated immune globulin, 17 were seropositive for HCV RNA. In addition, 1 of 35 patients not exposed to the contaminated immune globulin was HCV RNA-positive. HCV genotype V was found in all 12 patients for whom genotyping was performed, but 8 patients also had genotype II or III, or both. All HCV RNA-positive patients had abnormal results on biochemical liver tests. All liver-biopsy specimens (from 15 patients) were abnormal, with portal inflammation, bile-duct damage, and focal necrosis. In six patients there was cirrhosis. Two patients died of liver failure. In 4 of the 10 patients treated with interferon there were complete, though transient, biochemical responses, but the follow-up biopsy specimens showed evidence of histologic progression. The poorest responses to interferon were among the patients with multiple HCV genotypes. All but one patient remained positive for HCV RNA., Conclusions: In patients with primary hypogammaglobulinemia there was a high rate of HCV infection after treatment with contaminated immune globulin. In these immunocompromised patients HCV infection has a severe and rapidly progressive course, and responses to interferon are poor. (N Engl J Med 1994;331:1607-11)., Owned, published, and (C) copyrighted, 1994, by the MASSACHUSETTS MEDICAL SOCIETY1 aBjoro, Kristian1 aFroland, Stig1 aYun, Zhibing1 aSamdal, Helvi1 aHaaland, Terese.  uhttps://notifylibrary.org/reference/4061