Low fibrosis progression of recurrent hepatitis C in apolipoprotein E epsilon4 carriers: relationship with the blood lipid profile.
BACKGROUND
The histological outcome of chronic hepatitis C is better among carriers of the apolipoprotein E (ApoE) epsilon4 allele, for reasons unknown. The orthotopic liver transplantation (OLT) setting allows to separate the role played by liver-derived ApoE (graft) from ApoE of different origin (recipient).


METHODS
Forty-six OLT recipients with recurrent hepatitis C were studied. Grafts and recipients were genotyped for ApoE. In a follow-up extending up to 4 years, the serum triglycerides-to-cholesterol ratio (T/C ratio) was measured 1 year after OLT, whereas fibrosis progression was assessed yearly and expressed as fibrosis units/month (FU/mo).


RESULTS
A T/C ratio < or =0.75 was observed in 13/15 cases in which both donor and recipient were epsilon4 carriers, 10/19 cases in which epsilon4 alleles were of exclusive recipient's origin and 5/12 cases in which epsilon4 alleles were of exclusive donor's origin or absent (P<0.02). One year after OLT, a fibrosis progression < or =0.100 FU/mo was associated with a low T/C ratio (24/34 vs. 4/12, P<0.05). An Ishak staging score >2 was reached later by male recipients who were epsilon4 carriers (P<0.002).


CONCLUSIONS
Recipient's carriage of ApoE epsilon4 affects fibrosis progression of recurrent hepatitis C through gender-specific mechanisms, associated with a peculiar, ApoE-associated, lipid profile.
Fabris
Carlo
C
Liver Transplantation Unit, Department of Experimental and Clinical Pathology and Medicine (DPMSC), University of Udine, Italy.
Toniutto
Pierluigi
P
Bitetto
Davide
D
Minisini
Rosalba
R
Smirne
Carlo
C
Caldato
Maya
M
Pirisi
Mario
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics*; D018450:Disease Progression; D005260:Female; D005787:Gene Frequency; D019698:Hepatitis C, Chronic / Q000097:blood / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D006579:Heterozygote; D006801:Humans; D008055:Lipids / Q000097:blood*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology* / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D012008:Recurrence; D014019:Tissue Donors
D000998:Antiviral Agents; D053327:Apolipoprotein E4; D001057:Apolipoproteins E; D008055:Lipids