The clinical course of HCV infection in patients with primary hypogammaglob
ulinaemia appears to be more severe than in immunocompetent patients. We st
udied the long-term course of chronic HCV infection in 20 Norwegian hypogam
maglobulinaemia patients with a 13-15 year known history of HCV infection.
Twelve of 20 patients developed cirrhosis during the observation period (19
84-1999), and the remaining eight also had chronic liver disease verified b
y liver biopsy in the majority of the cases. Eleven of the 20 patients are
dead. Two died following liver transplantation for HCV cirrhosis. Five died
due to terminal liver failure without receiving a liver allograft. Two pat
ients died from other causes, but with advanced liver disease contributing
to the outcome, while two deaths were unrelated to the HCV infection. Among
patients with common variable immunodeficiency (CVI), five out of six are
dead. Two patients cleared the hepatitis C virus 3 years following interfer
on monotherapy, while three patients achieved a sustained response to combi
nation therapy with interferon and ribavirin. Viral load did not seem to ha
ve a major impact on disease progression. Our results emphasize the severit
y of hepatitis C virus infection in patients with hypogammaglobulinaemia. P
atients with CVI appear to have the poorest prognosis.