SERUM HEPATITIS-C RNA TITERS AFTER LIVER-TRANSPLANTATION ARE NOT CORRELATED WITH IMMUNOSUPPRESSION OR HEPATITIS

The degree to which immunosuppression and/or rejection influences recu rrent hepatitis C (HCV) after liver transplantation (LT) for end-stage HCV cirrhosis remains poorly defined, We quantified serum HCV-RNA in 84 serum samples from 28 anti-HCV-positive patients taken 223 days pri or to and up to 1719 days after liver transplantation to determine if cumulative immunosuppression rejection, or histologic recurrence corre lated with HCV-RNA levels, Histologic, serum chemistry, cumulative ste roid, and OKT3 and alpha-interferon (INF) dose data were collected at the time of HCV-RNA sampling, Eighteen of 24 evaluable patients (75%) had HCV-RNA detected in their sera after transplant, Eight patients ha d 14 rejection episodes, 9 patients received OKT3, and 5 were given IN F for histologically moderate hepatitis, Five patients died-two of rec urrent hepatitis C-and no retransplants were performed for recurrent h epatitis, Of the 23 survivors, 7 have histologic hepatitis-1 with pers istent ascites, and 2 with mild fibrosis, We could show no correlation between HCV-RNA levels and any of the variables examined although a t rend toward increasing HCV-RNA levels with increasing numbers of rejec tion episodes was observed. In addition, histologic recurrence occurre d more frequently for patients treated with OKT3. We conclude that the quantity of circulating viral genome is not influenced by immunosuppr essive load and does not correlate with laboratory or histologic signs of recurrence, The roles that rejection, and possibly OKT3, play in t he recurrence of HCV after liver transplant need further study.