FATAL HEPATITIS-C VIRUS-INFECTION IN A HEART-TRANSPLANT RECIPIENT DETECTABLE BY POLYMERASE CHAIN-REACTION ONLY

Rapidly progressive and ultimately fatal liver failure with evolution to cirrhosis developed in a heart transplant recipient following infec tion by hepatitis C virus. Antiviral antibodies and the presence of vi ral RNA were analyzed throughout the course of the disease. After a we ak initial response to a single viral epitope (c22-3), serology became negative, the infection remaining detectable by polymerase chain reac tion only. This case demonstrates the potentially severe consequences of hepatitis C virus infection under immunosuppression. The incidence of this infection may be underestimated, as the presented case apparen tly would not have been detected if serology had been used for diagnos is. (C) Journal of Hepatology.