The course of hepatitis C virus infection after liver transplantation.
Hepatitis C virus-induced liver disease is becoming a main indication for liver transplantation. Recurrence of hepatitis after transplantation has been reported, but its long-term consequences are unknown. Seventy-nine patients positive for hepatitis C virus (group 1) and 106 subjects negative for hepatitis C virus antibody (group 2) with a mean follow-up of 4 yr were retrospectively studied by means of serology, nested polymerase chain reaction and branched-DNA technology before and after liver transplantation. The actuarial rates of hepatitis C virus-related acute hepatitis were 72% and 20% at 4 yr in groups 1 and 2, respectively. Progression to chronic active hepatitis occurred in 61% and 36% of the subjects within 3 yr of the onset of recurrent and acquired hepatitis, respectively. No case of acute graft failure and two cases of cirrhosis were related to recurrent or acquired hepatitis C virus liver disease. Hepatitis C virus RNA levels were significantly increased in cases of hepatitis after transplantation. In contrast, the pretransplant hepatitis C virus RNA level was not predictive of recurrence. Our results establish the general persistence of hepatitis C virus infection after liver transplantation, the frequency and the severe course of recurrent liver disease. However, liver transplantation in hepatitis C virus antibody-positive patients still has a good medium-term prognosis.
Féray
C
C
Hepatobiliary and Liver Transplant Service, Hospital Paul Brousse, University of South Paris, Villejuif, France.
Gigou
M
M
Samuel
D
D
Paradis
V
V
Wilber
J
J
David
M F
MF
Urdea
M
M
Reynes
M
M
Bréchot
C
C
Bismuth
H
H
D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006085:Graft Survival; D016174:Hepacivirus / Q000235:genetics / Q000502:physiology; D006526:Hepatitis C / Q000601:surgery* / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications; D012367:RNA, Viral / Q000032:analysis; D012008:Recurrence; D012189:Retrospective Studies; D014779:Virus Replication
D004279:DNA, Viral; D012367:RNA, Viral