Five-year follow-up of patients with primary antibody deficiencies following an outbreak of acute hepatitis C

This report is the 5-year follow-up of those 25 UK patients with primary an tibody deficiencies infected with hepatitis C virus (HCV), type la, from on e batch of contaminated anti-HCV-screened intravenous immunoglobulin in 199 3-1994, Of these patients, who were reported previously (1, 2), 2 cleared H CV spontaneously, 18 received early interferon-cu (IFN) treatment for 6 mon ths, and 5 declined treatment or treatment was contraindicated, The clinica l course of this cohort was followed prospectively using serial standardize d questionnaires, Seven patients (54% of those who had completed therapy) h ad a sustained response (normal transaminase levels, negative serum HCV RNA ) for 5 years posttreatment, Eight patients died: 3 from decompensated cirr hosis, 2 from pneumonia but with evidence of liver failure, and 3 from unre lated causes. One further patient developed decompensated cirrhosis but was successfully transplanted. Seven patients remain chronically infected; onl y 1 patient is symptomatic but 1 further patient has evidence of progressiv e fibrosis on liver histology, In conclusion, within 5 years, rapid end-sta ge HCV liver disease has been seen in 6/25 (24%) patients. Seven patients, (54% of those fully treated) remain well after treatment, making 9/25 (36% of the cohort) clear of virus after 5 years. Those who completed early trea tment with IFN had a relatively high sustained response rate compared to pr evious studies in both immunodeficient and immunocompetent patients. (C) 20 01 Academic Press.