Antibody response to hepatitis C virus infection after liver transplantation.
OBJECTIVE
To determine whether liver transplantation and the subsequent immunosuppression affect the antibody response to hepatitis C virus (HCV) infection.


METHODS
Sera from 46 patients were compared before and after liver transplantation for markers of HCV infection. Serum HCV RNA was determined by polymerase chain reaction (PCR). Anti-HCV antibody was determined by first- and second-generation immunoassays as well as a quantitative assay of the titer of anti-HCV core antibody.


RESULTS
Among individuals who acquired hepatitis C infection in association with liver transplantation, only 15% (3/12) developed antibody to the core antigen and only 25% (3/12) reacted to any antigen present on the second-generation recombinant immunoblot assay after a mean follow-up period of 18 months. Thirty-eight percent (5/13) were positive, by the second-generation enzyme immunoassay (EIA-2) Whereas 94% (16/17) of the individuals who had detectable anti-HCV core antibodies pretransplant continued to have such antibodies after transplant, the titer of these antibodies declined an average of 4-fold. No significant change was seen in the antibody titer toward rotavirus, a common viral pathogen. Patients who acquired HCV infection or in whom the allograft became reinfected had a significantly increased incidence of posttransplant hepatitis (61% vs. 33%, respectively).


CONCLUSIONS
Liver transplantation and posttransplant immunosuppression lead to an attenuated antibody response to hepatitis C viral infection. Currently available assays for anti-HCV antibodies may be unreliable in the posttransplant setting.
Hsu
H H
HH
Department of Medicine, Palo Alto VA Medical Center, California.
Wright
T L
TL
Tsao
S C
SC
Combs
C
C
Donets
M
M
Feinstone
S M
SM
Greenberg
H B
HB
D000328:Adult; D005260:Female; D016174:Hepacivirus / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000032:analysis*; D006526:Hepatitis C / Q000453:epidemiology / Q000276:immunology*; D018937:Hepatitis C Antibodies; D006801:Humans; D015151:Immunoblotting; D007124:Immunoenzyme Techniques; D007165:Immunosuppression Therapy; D015994:Incidence; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood
D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D012367:RNA, Viral