Hep C Discussion Forum

I am kinda taking this"vets" thing off topic, forgive me, but loosely this could still apply, as vets may have been recipients of gamma globulin shots. Couldn't rightly decide where this post should go!

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Q:  Are immunoglobulins the same things as gamma globulins?

A:  Weeeell, the short answer is yes, the longer answer is kinda, and no, depending.

(Here is some reading, following, that should make the whole sticky issue of gamma globulin-gobbledegook as clear as serum).

Q:  If you have ever received a gamma globulin IM injection (ho-lee cow do they ever hurt!!), then, be glad they picked your largest muscle, gluteous maximus/butt muscle, to withstand this large gauge spike and in the trying to absorb the insult of the gigantic oily-looking painful dose of golden liquid goodwill over the next hours and days!) ... if you have been so lucky to be the recipient of one of these (seemed in vogue in the '70's), don't you wish you had received it well after the 1990's?

A:  Repeat after me - yes!

Wiki - Gamma globulins are a class of globulins, identified by their position after serum protein electrophoresis. The most significant gamma globulins are immunoglobulins (antibodies), although some immunoglobulins are not gamma globulins, and some gamma globulins are not immunoglobulins.

Gamma globulin injections are usually given in an attempt to temporarily boost a patient's immunity against disease. Being a product derived from blood, gamma globulin injections, along with blood transfusions and intravenous drug use, can pass along hepatitis C to their recipients. Once hepatitis C was identified in 1989, blood banks began screening all blood donors for the presence of the virus in their bloodstream. However, since hepatitis C is known to have been present since at least the 1940s, a gamma globulin shot received prior to the early 1990s put the recipient at risk of being infected.

Injections are most commonly used on patients having been exposed to hepatitis A or measles, or to make a kidney donor and a recipient compatible regardless of blood type of tissue match. Injections are also used to boost immunity in patients unable to produce gamma globulins naturally because of an immune deficiency, such as X-linked agammaglobulinemia and hyper IgM syndrome. Such injections are less common in modern medical practice than they were previously, and injections of gamma globulin previously recommended for travelers have largely been replaced by the use of hepatitis A vaccine.

Medscape - Immune globulin products from human plasma were first used in 1952 to treat immune deficiency. Intravenous immunoglobulin (IVIG) contains the pooled immunoglobulin G (IgG) immunoglobulins from the plasma of approximately a thousand or more blood donors. (A THOUSAND donors!!) Initially, immune globulin products were administered by intramuscular injection.

Hmm, lets do the math, some say (nowadays) it takes "roughly" about 5 or 6 donors? to end up in the making of a 500cc bag of whole blood, fun trivia to know should one be in need a transfusion say.

And less than 5 or 6 donors? Are required to make a 250cc bags of other stuff - plasma, packed cells/platelets, factors and other derivatives. Something like that anyway.

(These were all just "very rough" guessings from elsewhere "blog" postings.)

A wise, experienced person, told me an "in the olden times" true story, where people were given bags of whole blood contaminated with hepc (and/or whatever). To this day, quite a few people usually end up getting more than one bag of blood too (for the good reason why they probably needed it in the first place, to correct a death defying blood volume loss)! Roughly averaged, if you're hemorrhaging, you might get about 3 bags of blood, give or take, depending on how much of a very bad a day you may be having. This person said it was akin to having a hepc bomb go off inside them! I guess so!, just thinking of the vastly tiny amounts of blood product a person may be subjected to say from a contaminated syringe or a mere pin prick for that matter and then contracts hepc, multiple that by 500 ccs X 3 of pre-1990 vintage blood being squeezed into you as fast as they dare. Bigger risk you think?

Now, here's where I wish I actually attended some of those math classes in high school, maybe some of those english classes too, and while I'm at it, how I wished I had not hung around with any of those kids who turned yellow, now that I'm wistfully re-visiting the past ...

Q:  How many donors (kindly willing inmates or otherwise) contributed to give me my aprox 45cc IM bolus of gamma globulin spiked into my derriere muscle way back when in the '70's?

A:  ?

Here's a neat old study about hep A, a very fine year. A year I was merely a thought in my parents mind. If the topic of the hepc epidemic was not such a serious subject, I would admit the ironic concepts in this study were making me giggle out loud, in the oddest sort of way.

Calif Med. 1954 Sep; 81(3): 226-229.PMCID: PMC1532125

PREVENTION OF INFECTIOUS HEPATITIS BY GAMMA GLOBULIN

Charles I. Leftwich

Infectious hepatitis, a viral disease, has become increasingly more important in recent years. It is believed that the great increase in reported cases is not due entirely to better reporting, but that there has been an actual increase in the incidence of this disease. The comparatively long incubation period in infectious hepatitis, the high incidence in persons in close contact with patients who have the disease, and the fact that in most instances contact between persons is the mode of spread, makes this disease particularly suitable for the use of an immunizing agent which would be administered after exposure.

From the studies reviewed it is apparent that gamma globulin is of value in preventing hepatitis both when administered as mass prophylaxis in an epidemic, and when given to persons in close contact with a person who has the disease. Widespread use of gamma globulin prophylactically among persons who have been in close contact with the occasional patients with infectious hepatitis seen by practicing physicians might often obviate the need for mass immunization. (hm, dejevu all over again, how did we ever get to be in such an upsurging epidemic of hepc c? today, some things never change, now we are in need of the preventative goodness of hepc mass immunization!). It should be stated that there is little evidence for the effectiveness of gamma globulin in the therapy of infectious hepatitis. In a study in which very large amounts (average dose 45 cc.) of gamma globulin were given very early in the disease, no significant difference was observed between those injected and a control group. (Huh ... what?!)

Oh, the good ole days.  

Hmm, earlier in this thread, I noted all you guys had already got me to thinking about that "gun" immunization I got as a kid!, 1965 era? ... Now, you guys got me to thinking again, what about that "gamma-globulin" shot I got (prophylactically), a thing they tended to do way back when, in the "ole" days, as a "potential preventative" if they thought you had been exposed to someone with hep A (think that was 1972?), heard since then, that those kind of "blood/serum derived products" (like gamma-globulin) could have held unwanted ammo too!  C. 

Hey Brother,

After all the years of following this thought, my radar goes off every time I hear a Vet say they have no idea how this could've happened. When asked if they received boot camp air gun vaccinations and they say yes... Not much of a head scratcher, but that's just an opinion. Of course it might be global warming! 

We have to stay on top of this, there are way too many questions left unanswered on those air gun vaccinations. The VA has started providing treatment to any Vet with HCV, but we'll never see the DOD/VA admit those vaccinations were to blame. They'll just wait for us to fade away...   Ain't happening anytime soon though!! Keep up the pressure in the meantime.

Thanks for all the replies so far and sorry that I haven't updated my 'signature' for so long.  I'll try to fumble thru that and get up to date with my current info.

re: my fibroscan grade/score..............I was just guessing from my foggy mind, but I am sure that my liver had advanced to fibrosis and remember the Thai liver specialist saying that I was just .1 notch below cirrhosis.  Also, it could have been on a different scale [?]............I'll try to find the report that was stashed in a box with all my other medical records, mostly from Thailand.

Thanks Tig for editing my link and I hope that it can be of some help to someone.  As you know, US Vietnam vets have the highest rate of HCV than any other group and you're probably right in that they won't admit that they were at fault for spreading the virus in the hopes that we'll all die off before they do admit guilt............but I'm gonna fight!!! [except that my fatigue is taking most of the fight that I have left in me]

I agree Phyllis. It's very important that people are adequately informed when dealing with treatment like this. In addition to our physicians, we're glad to be here as a resource too. 

I'm sorry you're not back where you want to be. I hope you find the answer soon. The sides tend to be easy for most, but irritating for many others. The depression seems to be common with HCV anyway and these drugs can amplify it. I had a real problem with it, but noticed improvement following SVR. Don't get too down, it does get better!

Hello,

I had all of my vaccinations with those guns. US Navy 1974, thank you... I can relate to your sentiment over it. Thanks for the link, I shortened it for sake of space. I enjoyed seeing it in writing. Do you think they'll admit responsibility or keep piecemealing it til we're gone?

Hope you get to feeling better soon. It's hard enough to get going each day, we don't need any extra help! If your Fibroscan was 3.9 kPa you aren't cirrhotic. More like mild fibrosis (F0-F1) according to the FS scoring chart. This is good news, right?!? Ya buddy! Here's some info:

Fibroscan Scoring

Hi VetwithC,

I am very glad to meet you here, but of course not because of the circumstance.

I am SO glad you are going to get started on your Harvoni soon.

Tig (and many others will soon be along to meet and greet you), you will be very welcome here.

Your news story (thank you for attaching it) is one that some of us are very familiar with, and some not so much. An important story of event and special circumstance. Tig and some of the others have intimate knowledge of what you bring up and speak on.

Please do share as much as you wish to with us. How is your Fscore now, going into your Harvoni treatment?

I am glad you have come here, and posted and going to start your Tx.  C.