Hepatitis C in liver allografts.
Recurrent or intercurrent hepatitis C represents significant problems in patients with liver transplants and must be differentiated from hepatic allograft rejection and other conditions affecting allografts. Often, the currently available anti-hepatitis C virus (HCV) tests are not helpful in the differential diagnosis, because preexisting anti-HCV may persist after transplantation or its development may be delayed. We determined the presence of HCV RNA by the reverse double polymerase chain reaction in biopsy specimens of liver allografts from nine patients with acute or chronic hepatitis of uncertain origin and from three patients with cellular allograft rejection. The NS3 region sequences of HCV were detected in seven of nine liver allograft biopsy specimens 6 weeks to 20 months after transplantation. Hepatitis C virus RNA was not detected in two patients. One of these patients was anti-HCV positive, showing mild acute hepatitis 5 weeks after transplantation. Anti-HCV was present in three patients with detectable HCV RNA in the liver but was absent from four other patients with HCV RNA. These findings suggest that HCV is a major cause of acute and chronic hepatitis following liver transplantation, that detection of HCV RNA by polymerase chain reaction in the liver biopsy specimen represents a reliable method for the diagnosis of hepatitis C in liver allografts, and that in some patients HCV may be acquired during transplantation while in others it may represent a recurrent infection.
Thung
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Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai School of Medicine, City University of New York, NY 10029.
Shim
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Shieh
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Schwartz
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M
Theise
N
N
Borcich
A
A
Katz
E
E
Miller
C
C
Gerber
M A
MA
D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D016031:Liver Transplantation / Q000473:pathology*; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis
D012367:RNA, Viral