Liver transplantation
Recurrence of HCV infection in liver transplant patients: evaluation of IgM anti-HCV and IgM anti-CMV

https://doi.org/10.1016/S0041-1345(03)00256-2Get rights and content

Section snippets

Patients and methods

We prospectively studied 129 consecutive anti-HCV-positive transplant patients (95 men and 34 women, mean age at transplantation 55 years, range 34 to 67 years) of whom 84 required transplantation because of terminal liver failure and 45 because of hepatocellular carcinoma in cirrhosis. Genotype distribution, as assayed by Genotype HCV III (Nuclear Laser Medicine, Italy) was 1a in 13/129 (10.0%), lb in 92/129 (71.3%), 2a/2c in 14/129 (10.8%), 3a in 8/129 (6.2%), and 4 in 2/129 (1.5%).

The HCV

Results

Average follow-up post-liver transplant was 18 months (range 3 to 36 months). HCV RNA persisted in all but one patient. At liver biopsy, signs of hepatitis C recurrence were observed in 51/103 (49.5%), acute rejection in 33/103 (32.0%), and mixed signs of hepatitis rejection in 19/103 (18.4%) (Table 1).

Fluctuations in HCV RNA serum levels did not correlate with liver disease. Instead, IgM anti-HCV serum levels were increased in 39 (76.4%) patients with hepatitis but none with rejection; they

Discussion

Currently, liver histology is the best tool to differentiate recurrent hepatitis C and acute rejection, even though hepatitis recurrence and rejection display many overlapping factors.1, 7 A previous study10 reported 98 patients with 86 liver biopsies; monthly monitoring of IgM anti-HCV provided a useful diagnostic tool in liver transplant patients that seemed to avoid an invasive procedure like liver biopsy when IgM anti-HCV levels increased at the time of an ALT flare. In the present study,

References (13)

  • E.P Molmenti et al.

    Liver Transpl

    (2002)
  • G.J Nuovo et al.

    Hum Pathol

    (2002)
  • D.A Neil et al.

    Hepatology

    (2002)
  • G Ballardini et al.

    Liver Transpl

    (2002)
  • A Humar et al.

    Transplantation

    (2002)
  • A.S Gouw et al.

    Transplantation

    (2002)
There are more references available in the full text version of this article.
View full text