Recurrent and new hepatitis C virus infection after liver transplantation

TitleRecurrent and new hepatitis C virus infection after liver transplantation
Publication TypeJournal Article
Year of Publication1999
AuthorsEverhart JE, Wei Y, Eng H, Charlton MR, Persing DH, Wiesner RH, Germer JJ, Lake JR, Zetterman RK, Hoofnagle JH
Pagination1220 - 1226

Abstract 10.1002/hep.510290412.abs Chronic infection with the hepatitis C virus (HCV) is the most common reason for liver transplantation. We examined the results of laboratory tests for HCV on a cohort of patients who received a liver transplant between 1990 and 1994 at three large centers. Seven hundred twenty-two recipients and 604 donors were tested for antibody to HCV (anti-HCV) using a second-generation enzyme-linked immunoassay (EIA-2), followed by recombinant immunoblot (RIBA-2) and HCV RNA confirmation by reverse-transcription polymerase chain reaction (RT-PCR) (with genotyping and viral quantification). Diagnosis of posttransplantation infection required detection of serum HCV RNA that could be genotyped by sequencing or was repeatedly positive despite being unsequenceable. Twenty-five percent of transplantation candidates were seropositive for anti-HCV. Approximately 86% of anti-HCV–positive, 93% of RIBA-positive, and 97% of HCV RNA–positive candidates developed infection after transplantation. Pretransplantation HCV RNA was superior to RIBA-2 for predicting posttransplantation infection. Whereas HCV genotype was identified in nearly all candidates and changed little after transplantation, serum viral levels rose markedly after transplantation. Fifteen donors were either anti-HCV– or HCV RNA–positive. Recipients of grafts from donors with HCV RNA all developed infection, whereas infection was not detected in recipients of grafts from donors with anti-HCV but without detectable HCV RNA. The rate of new infection fell significantly (P = .02) after the introduction of EIA-2 screening of blood. Donor and candidate markers for HCV predict posttransplantation infection

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