title: Recurrence of hepatitis C after liver transplantation is associated with increased systemic IL-10 levels.
abstract: BACKGROUND
  Recurrence of hepatitis C after liver transplantation is an almost universal occurrence. T-cell derived cytokines have an important role in the development of liver damage associated with chronic hepatitis C, their post-transplant levels, however, have not been correlated with histologic recurrence of the disease.
  
  
  OBJECTIVE
  We sought to analyze levels of TNF-alpha, soluble IL-2 receptor, IL-4 and IL-10 at 1 month, 6 months and 1 year after transplantation in 27 patients undergoing transplantation for hepatitis C related end-stage liver disease.
  
  
  METHODS
  HCV RNA levels were monitored by a branched-chain DNA signal amplification assay. Diagnosis of recurrent hepatitis was based on 1-year protocol biopsies and on biopsies performed for liver enzyme elevations.
  
  
  RESULTS
  Recurrent hepatitis C was detected in 52% (n=14) of the 27 patients. HCV RNA levels rose over time in all patients regardless of histologic recurrence. TNF-alpha, and IL-4 levels, although elevated, did not show specific patterns over time or in correlation with recurrence. Similarly, the early elevation followed by a gradual decrease over the first year in the amount of soluble IL-2 receptor was not related to histologic recurrence. We observed a significant increase in circulating IL-10 levels over the first year in patients with biopsy-proven recurrence, while patients with no signs of histologic recurrence displayed increased, but steady levels.
  
  
  CONCLUSIONS
  These results suggest that while these cytokines are associated with post-transplant recurrence of hepatitis C, their production may be altered by additional factors.
authors.affiliation: The Recanati Miller Transplantation Institute, Mount Sinai School of Medicine, New York, NY 10029, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Sheiner
authors.forename: S S
authors.initials: SS
authors.lastname: Florman
authors.forename: S
authors.initials: S
authors.lastname: Emre
authors.forename: T
authors.initials: T
authors.lastname: Fishbein
authors.forename: M E
authors.initials: ME
authors.lastname: Schwartz
authors.forename: C M
authors.initials: CM
authors.lastname: Miller
authors.forename: P
authors.initials: P
authors.lastname: Boros
mesh_terms: D006526:Hepatitis C / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016753:Interleukin-10 / Q000097:blood*; D015847:Interleukin-4 / Q000097:blood; D008103:Liver Cirrhosis / Q000517:prevention & control*; D016031:Liver Transplantation; D016853:Muromonab-CD3 / Q000627:therapeutic use; D012367:RNA, Viral / Q000097:blood; D015375:Receptors, Interleukin-2 / Q000097:blood; D012008:Recurrence; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D007166:Immunosuppressive Agents; D016853:Muromonab-CD3; D012367:RNA, Viral; D015375:Receptors, Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D015847:Interleukin-4