Five-Year Follow-up of Patients with Primary Antibody Deficiencies Following an Outbreak of Acute Hepatitis C

Chapel, Helen; Christie, Jane; Peach, V.; Chapman, Roger W.

doi:10.1006/clim.2001.5036

Cited by 47 publications

(42 citation statements)

References 25 publications

(18 reference statements)

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“…Second, nAb titers are associated with lack of disease progression in long-term survivors during HIV infection (27). Finally, HCV-infected patients with primary Ab deficiencies have been reported to have accelerated rates of disease progression (28,29). The lymphocytic choriomeningitis virus (LCMV) murine model is often cited as an example of effective cytotoxic T lymphocyte (CTL) control of a virus infection; however, the kinetics of virus elimination do not always correlate with development of a CTL response.…”

Section: Discussionmentioning

confidence: 99%

Neutralizing antibody response during acute and chronic hepatitis C virus infection

Logvinoff

Major

Oldach

et al. 2004

Proc. Natl. Acad. Sci. U.S.A.

371

328

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Little is known about the role of Abs in determining the outcome of hepatitis C virus (HCV) infection. By using infectious retroviral pseudotypes bearing HCV glycoproteins, we measured neutralizing Ab (nAb) responses during acute and chronic HCV infection. In seven acutely infected health care workers, only two developed a nAb response that failed to associate with viral clearance. In contrast, the majority of chronically infected patients had nAbs. To determine the kinetics of strain-specific and crossreactive nAb emergence, we studied patient H, the source of the prototype genotype 1a H77 HCV strain. An early weak nAb response, specific for the autologous virus, was detected at seroconversion. However, neutralization of heterologous viruses was detected only between 33 and 111 weeks of infection. We also examined the development of nAbs in 10 chimpanzees infected with H77 clonal virus. No nAb responses were detected in three animals that cleared virus, whereas strain-specific nAbs were detected in six of the seven chronically infected animals after Ϸ50 weeks of infection. The delayed appearance of high titer crossreactive nAbs in chronically infected patients suggests that selective mechanism(s) may operate to prevent the appearance of these Abs during acute infection. The long-term persistence of these nAbs in chronically infected patients may regulate viral replication.

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Section: Discussionmentioning

confidence: 99%

Neutralizing antibody response during acute and chronic hepatitis C virus infection

Logvinoff

Major

Oldach

et al. 2004

Proc. Natl. Acad. Sci. U.S.A.

371

328

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“…Subset 1 included a total of 12 cohort studies [6][7][8][9][10][11][12][13][14][15][16][17] that reported data on serum HCV-RNA clearance. The cohort studies of subset 1 were reviewed to assess the overall likelihood of sustained virological response in treated patients [6][7][8]10,12,13,[15][16][17] and the likelihood of spontaneous HCV RNA clearance in untreated controls [9,11,14], by the Confidence Profile Method using the Fast*Pro software [18][19][20].…”

Section: Search Strategy and Inclusion Criteriamentioning

confidence: 99%

When and how to treat acute hepatitis C?

Licata

Bona

Schepis

et al. 2003

Journal of Hepatology

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Background: Appropriate treatment of acute hepatitis C is still a matter of controversy due to the lack of large controlled trials.Aim: To assess the effectiveness of interferon as treatment for acute hepatitis C by meta-analysis. Methods: MEDLINE search (1985 -2002) was supplemented with manual searches of reference lists. Studies were included if they were controlled trials comparing interferon to no treatment and if they included patients with either post-transfusion or sporadic acute hepatitis C. Twelve trials were analyzed (414 patients). The outcome assessed was the sustained virological response (SVR) rate (undetectable hepatitis C virus RNA in serum at least 6 months after cessation of therapy).Results: Interferon significantly increased the SVR (risk difference 49%; 95% confidence interval 32.9 -65%) in comparison to no treatment. The risk difference of SVR increased from 5 to 90% when trials were ordered by increasing interferon weekly dose. Delaying therapy by 8 -12 weeks after the onset of disease does not compromise the SVR rate.Conclusions: Current evidence is sufficient to recommend interferon treatment of patients with acute hepatitis C. A later initiation of therapy yields the same likelihood of response as early treatment. A daily induction dose during the 1st month is the best option of treatment. q

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“…59 -61 Viral transmission has not been reported since the last outbreak of HCV in 1994. 62,63 Home therapy Patients and their carers can be trained to undertake therapy at home. 64,65 Once patients are stabilized and can tolerate therapy, usually with i.v.…”

Section: Risks Of Immunoglobulin Therapymentioning

confidence: 99%

Primary antibody deficiency syndromes

Wood

2009

Ann Clin Biochem

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The primary antibody deficiency syndromes are a group of rare disorders characterized by an inability to produce clinically effective immunoglobulin responses. Some of these disorders result from genetic mutations in genes involved in B cell development, whereas others appear to be complex polygenic disorders. They most commonly present with recurrent infections due to encapsulated bacteria, although in the most common antibody deficiency, Common Variable Immunodeficiency, systemic and organ-specific autoimmunity can be a presenting feature. Diagnostic delay in this group of disorders remains a problem, and the laboratory has a vital role in the detection of abnormalities in immunoglobulin concentration and function. It is critical to distinguish this group of disorders from secondary causes of hypogammaglobulinaemia, in particular lymphoid malignancy, and appropriate laboratory investigations are of critical importance. Treatment of primary antibody deficiencies involves immunoglobulin replacement therapy, either via the intravenous or subcutaneous route. Patients remain at risk of a wide variety of complications, not all linked to diagnostic delay and inadequate therapy. In common variable immunodeficiency (CVID) in particular, patients remain at significantly increased risk of lymphoid malignancy, and regular clinical and laboratory monitoring is required. This review aims to give an overview of these conditions for the general reader, covering pathogenesis, clinical presentation, laboratory investigation, therapy and clinical management.

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Five-Year Follow-up of Patients with Primary Antibody Deficiencies Following an Outbreak of Acute Hepatitis C

Cited by 47 publications

References 25 publications

Neutralizing antibody response during acute and chronic hepatitis C virus infection

Neutralizing antibody response during acute and chronic hepatitis C virus infection

When and how to treat acute hepatitis C?

Primary antibody deficiency syndromes

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