ABSTRACT
Hepatitis C The risk of transmission of hepatitis C and other viral agents by gammaglobulin is discussed in detail in another chapter. The question has been raised whether patients with immune deficiency are particularly susceptible to infection with hepatitis C or if the disease is more severe in these patients (61 ,62). The first repon of non-A, non-B hepatitis associated with infusions of intravenous gammaglobulin was that of Lane from the Blood Products Laboratory in England (63). Twelve hypogammaglobulinemic patients developed hepatitis consistent with non-A, non-B hepatitis; more specific testing was not available in 1983. Two of the patients were mildly icteric for a short period, and the others had mild elevations in aminotransferase levels that persisted for more than 10 months (63,64). However, upon follow-up 3 years later, at least six of the patients showed signs of progressive disease (65). Five still had very high ALT levels, one of whom complained of lethargy and had a large tender liver. One patient died of sepsis secondary to bone marrow failure that occurred shortly after the onset of the hepatitis. Several patients had evidence of cirrhosis on biopsy.
