[Course of the recurrence of hepatitis C virus infection after liver transplantation].
OBJECTIVE
Hepatitis C virus recurrence is frequent after orthotopic liver transplantation. The aim of this study was to evaluate the clinical, biological, and histological characteristics of recurrence.


METHODS
One hundred and ten patients (91 males, mean age 49 years) with liver transplantation were followed up for more than 1 year (mean: 26 months, range: 12-71). Hepatitis C virus serologic 2nd generation tests were performed before and every 3 months after transplantation in all patients. Serum RNA was detected every 6 months after transplantation by polymerase chain reaction. A percutaneous liver biopsy was performed every year in all patients and in case of abnormal biological liver tests.


RESULTS
In 44 patients (40%), hepatitis C virus serology was positive before transplantation, and was unchanged after transplantation. In this group histologic chronic hepatitis was observed in 35 patients (79.5%). The mean Knodell score was 8.4 +/- 2.3, associated with an increase in serum aminotransferases (> twice the upper limit of normal) in 26 cases (74.3%) and with serum RNA in 33 cases (94.3%). The Knodell score was not significantly higher 2 years or more after transplantation than before (9.5 +/- 3.9 vs 7.2 +/- 3.5). In 66 patients with negative hepatitis C virus serology before transplantation, no changes were noted after transplantation. In this group, histologic chronic hepatitis was found in 14 cases (21.2%) associated with serum hepatitis C virus RNA in 7 cases. Actuarial survival rates of the two groups were 97.1% and 91.2% at 2 years, and 93.5% and 86.7% at 5 years, respectively. No death clearly related to hepatitis C virus recurrence was observed.


CONCLUSIONS
Hepatitis C virus recurrence after liver transplantation is frequently associated with chronic hepatitis, and a progressive increase in liver lesions. Nevertheless, the 5-year survival rates was not different in these patients compared to patients with negative hepatitis C virus serology before transplantation.
Gugenheim
J
J
Service de Chirurgie Digestive et de Transplantation Hépatique, Hôpital Saint-Roch, Université de Nice.
Baldini
E
E
Ouzan
D
D
Mazza
D
D
Saint-Paul
M C
MC
Goubaux
B
B
Mouiel
J
J
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D005260:Female; D016174:Hepacivirus; D006526:Hepatitis C / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012367:RNA, Viral / Q000032:analysis; D012008:Recurrence; D012698:Serologic Tests; D013997:Time Factors
D012367:RNA, Viral