BACKGROUND & AIMS: The pathogenesis of graft injury in liver transplant recipients with recurrent hepatitis C virus (HCV) infection remains poortly understood. In this study, the relationship between HCV replication, genotype, and the evolution of graft damage was investigated. METHODS: HCV RNA was quantified in 184 protocol sera from 25 patients trasnplanted for HCV cirrhosis. HCV isolates were genotyped, and hepatic expression of core and NS4 antigens was sought in protocol allograft biopsy specimens. RESULTS: Acute lobular hepatitis was accompanied by a steep increase in HCV RNA levels and the appearance of core in NS4 antigens in the graft. Methylprednisolone treatment for acute rejection led to a 4-100-fold increase in serum HCV RNA. At the end of follow-up, HCV RNA levels were 3-112 times pretransplant levels and were higher in patients with more severe hepatitis. Progressive liver damage deeloped in 7 of 14 patients with HCV genotype 1b and 1 of 11 patients infected with other genotypes (P = 0.03). CONCLUSIONS: Peak viremia levels and the initial deterction of HCV antigens in hepatocytes suggests increased viral replication at the time of acute HCV hepatitis in the graft. Genotype 1b and higher viremia levels were associated with more severe chronic graft damage.
A longitudinal analysis of hepatitis C virus replication following liver transplantation
MONDELLI, MARIO UMBERTO;
1996-01-01
Abstract
BACKGROUND & AIMS: The pathogenesis of graft injury in liver transplant recipients with recurrent hepatitis C virus (HCV) infection remains poortly understood. In this study, the relationship between HCV replication, genotype, and the evolution of graft damage was investigated. METHODS: HCV RNA was quantified in 184 protocol sera from 25 patients trasnplanted for HCV cirrhosis. HCV isolates were genotyped, and hepatic expression of core and NS4 antigens was sought in protocol allograft biopsy specimens. RESULTS: Acute lobular hepatitis was accompanied by a steep increase in HCV RNA levels and the appearance of core in NS4 antigens in the graft. Methylprednisolone treatment for acute rejection led to a 4-100-fold increase in serum HCV RNA. At the end of follow-up, HCV RNA levels were 3-112 times pretransplant levels and were higher in patients with more severe hepatitis. Progressive liver damage deeloped in 7 of 14 patients with HCV genotype 1b and 1 of 11 patients infected with other genotypes (P = 0.03). CONCLUSIONS: Peak viremia levels and the initial deterction of HCV antigens in hepatocytes suggests increased viral replication at the time of acute HCV hepatitis in the graft. Genotype 1b and higher viremia levels were associated with more severe chronic graft damage.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
