Liver transplantationRecurrence of HCV infection in liver transplant patients: evaluation of IgM anti-HCV and IgM anti-CMV
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,
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Antiviral interventions for liver transplant patients with recurrent graft infection due to hepatitis C virus
2013, Cochrane Database of Systematic ReviewsAntiviral prophylaxis for the prevention of chronic hepatitis C virus in patients undergoing liver transplantation
2013, Cochrane Database of Systematic ReviewsAntiviral therapy for recurrent liver graft infection with hepatitis C virus
2009, Cochrane Database of Systematic Reviews