title: Role of hepatitis C virus in lymphoproliferative disorders after liver transplantation.
abstract: It has been suggested that hepatitis C virus (HCV) infection could be associated with B-cell clonal expansion. The aim of this study was to analyze the relationship between lymphoproliferative disorders and HCV infection in liver transplant recipients. We studied 157 patients receiving a liver transplant between January 1989 and May 1997 with a follow-up longer than 3 months. The incidence of posttransplant lymphoproliferative disorders (PTLDs) was analyzed with reference to the indication for liver transplantation, the induction and maintenance immunosuppression, the incidence of acute rejection episodes, and Epstein-Barr virus (EBV) infection. Six PTLDs occurred after a median posttransplant follow-up of 7 months (3.8%). Four of the 6 PTLDs occurred among the 38 patients transplanted for HCV-related cirrhosis, and 2 PTLDs occurred in the 119 patients receiving a liver transplant for non-HCV liver diseases (10.5% vs. 1.7%, respectively; P =.03). The 4-year probability of PTLD was significantly higher in patients receiving a liver transplant for HCV-related cirrhosis than non-HCV liver diseases (12.3% vs. 2.2%, respectively; P =.015). Patients receiving a liver transplant for HCV-related cirrhosis were more likely to receive antithymocyte globulins (ATG). However, in patients treated with ATG, the 4-year probability of PTLD was higher among those patients receiving a liver transplant for HCV-related cirrhosis than for non-HCV liver diseases (27.1% vs. 6.4%, respectively; P =.08). EBV gene products were detected in tumor tissues in 3 of 4 patients with HCV-associated PTLD. Our data suggest that, in addition to EBV infection, 2 mutually nonexclusive factors, i.e., the use of ATG and HCV infection, could play a role in the occurrence of PTLD after a liver transplant for HCV-related cirrhosis.
authors.affiliation: Departments of Hepatology-Gastroenterology, Hôpital Henri Mondor, Université Paris XII, Créteil, France.
authors.forename: C
authors.initials: C
authors.lastname: Hézode
authors.forename: C
authors.initials: C
authors.lastname: Duvoux
authors.forename: G
authors.initials: G
authors.lastname: Germanidis
authors.forename: F
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: A L
authors.initials: AL
authors.lastname: Vincens
authors.forename: P
authors.initials: P
authors.lastname: Gaulard
authors.forename: D
authors.initials: D
authors.lastname: Cherqui
authors.forename: J M
authors.initials: JM
authors.lastname: Pawlotsky
authors.forename: D
authors.initials: D
authors.lastname: Dhumeaux
mesh_terms: D000328:Adult; D000368:Aged; D001402:B-Lymphocytes / Q000276:immunology; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008213:Lymphocyte Activation; D008232:Lymphoproliferative Disorders / Q000209:etiology* / Q000821:virology; D008297:Male; D008875:Middle Aged