Specific immunoglobulin against HCV: new perspectives.

Evidence has suggested that the hepatitis C virus (HCV) does not elicit neutralizing antibodies, and hence that the presence of anti- HCV antibodies is only a marker of infection. Subsequently, HCV neutralizing antibodies have been identified and methods for their detection were devised. HCV neutralizing antibodies are present in anti-HCV-positive blood units but there is no correlation between the anti-HCV antibody titer and the HCV neutralizing antibody titer. There are two patented methods for the production of polyclonal HCV immunoglobulin: (i) from anti-HCV-positive blood units containing high titers of anti-HCV antibodies (EP-00447984); and (ii) from a large number of anti-HCV-positive blood units that contain high titers of HCV-neutralizing antibodies against the different HCV strains (US-06372216 and EP-00896545). Several monoclonal antibodies have been patented for clinical use in HCV-infected patients; however, only one has undergone a clinical trial. This review examines the use of specific immunoglobulin against HCV, which, similarly to specific immunoglobulin against hepatitis B virus, contains high titers of antibodies that neutralize the different HCV strains, and could thus be efficacious in the same settings (eg, re-infection of transplanted liver, post-exposure prophylaxis, sexual transmission and patients undergoing hemodialysis).