Effect of pretransplant hepatitis C virus RNA status on posttransplant outcome.
Undetectable hepatitis C virus (HCV) RNA [RNA(-)] before liver transplantation (OLT) has been shown to decrease the rates of disease recurrence. We sought to determine whether RNA(-) subjects differ in post-OLT recurrence (virological/VR, histological/HR), graft failure (GF), or patient survival from RNA(+) patients using a retrospective review. From 1995 to 2004, a total of 49 patients were RNA(-) at OLT as a result of interferon-based therapy: 22 SVR and 27 with end-of-treatment response (ETR) transplanted when RNA(-) within 6 months of ET. Forty-eight RNA(+) patients were analyzed as controls. Virological recurrence (VR) was seen in 55% of RNA(-) subjects with no difference in HR between RNA(-) vs (+) groups, namely 36.7% versus 56.3% (P = .068), respectively. The RNA(+) subjects showed a lower time to HR (5.6 vs 11 months; P = .027). The SVR subjects displayed lower VR (36.4%) and histological recurrence (HR) (13.6%) compared to ETR (VR 70.4%, P = .023; HR 55.6%, P = .003) or RNA(+) (HR 56%, P = .0008). The SVR subjects, who were identified with a sensitive assay (SVR(S), lower limit <600 IU/mL) showed no VR, HR, or GF. The 1- and 5-year survivals were 87.8%/75.6% and 89.6%/77.8% for RNA(-) and (+) groups, respectively (P = .77). In conclusion, RNA(-)-transplanted patients displayed lower VR and longer time to HR. The SVR patients showed lower VR and HR compared to ETR and RNA(+) patients.
Nudo
C G
CG
Center for Liver Diseases, Division of Hepatology, University of Miami, Leonard M. Miller School of Medicine, Miami, Florida 33136, USA. carmine.nudo@mail.mcgill.ca
Cortes
R A
RA
Weppler
D
D
Schiff
E R
ER
Tzakis
A G
AG
Regev
A
A
D000328:Adult; D000368:Aged; D005260:Female; D006085:Graft Survival; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D019562:Viral Load
D012367:RNA, Viral