TRANSMISSION OF HEPATITIS-C VIRUS IN ALLOGRAFTED PATIENTS - USE OF VIRAL GENOTYPING AS AN EPIDEMIOLOGIC MARKER

One hundred and ninty-two allografted patients were tested for hepatit is C virus (HCV) RNA from 1992 to 1995 in Saint-Louis Hospital (Paris) , They received blood products and intravenous immunoglobulins (IVIG) and more particularly Gammagard IVIG suspected of transmitting HCV (ba tches distributed in France between January 1993 and February 1994), T he presence of serum HCV RNA was tested by polymerase chain reaction ( PCR) in 86 patients who received Gammagard IVIG during the critical pe riod and in 106 patients treated with IVIG other than the suspected ba tches of Gammagard (negative controls), HCV RNA positive sera were HCV genotyped. Ten out of 86 patients who received Gammagard IVIG during the exposed period vs 0 out of 106 negative controls were HCV RNA posi tive showing a higher prevalence of HCV infection in the exposed patie nts than in the negative controls (P = 0.001), The link between HCV tr ansmission and IVIG infusion was reinforced by the high frequency of g enotype 2b (70%) in the exposed patients because genotype 2b is an und errepresented subtype in France (<1%).