Non-A, non-B hepatitis occurring in agammaglobulinaemic patients after intravenous immunoglobulin
Lever, A.M.; Webster, A.D.; Brown, D.; Thomas, H.C.
Lancet 2(8411): 1062-1064
1984
ISSN/ISBN: 0140-6736 PMID: 6150140 Document Number: 227547
Acute non-A, non-B hepatitis developed in 12 patients with primary hypogammaglobulinemia during treatment with i.v. gammaglobulin prepared by Cohn fractionation of pooled plasma. The illness was clinically and histologically identical to the short-incubation non-A, non-B, hepatitis observed in hemophilic patients receiving factor VIII concentrates. Most of the patients were symptomless, but 10 mo. after onset 10 of the 12 still had abnormal liver function. The occurrence of non-A, non-B hepatitis is agammaglobulinemics indicates that humoral mechanisms are not essential for production of hepatocyte necrosis in this infection. This outbreak emphasizes the need for a screening test to identify the agent in blood products and shows that Cohn fractionation of plasma does not always inactive the agent. The finding that the virus can be transmitted in IgG concentrates suggests either that the general population has a very low level of antibodies to the putative virus or that such antibodies are not virus-neutralizing.