INFLUENCE OF THE GENOTYPES OF HEPATITIS-C VIRUS ON THE SEVERITY OF RECURRENT LIVER-DISEASE AFTER LIVER-TRANSPLANTATION

Background/Aims: Several genotypes of hepatitis C virus (HCV) have bee n identified by phylogenetic analysis, but their clinical relevance re mains elusive, Liver transplantation for HCV-related cirrhosis offers a unique opportunity for prospective studies of this issue, Methods: S ixty anti-HCV-positive liver recipients with precise virological, and histological assessments were included, HCV genotype was determined wi th both type-specific capsid primers and a line probe genotyping assay . Results: HCV genotype Ib was the predominant type before transplanta tion (40 of 60 patients); after liver transplantation, acute and chron ic active hepatitis developed more frequently in these patients than i n patients infected by other genotypes (31 of 40 and 24 of 40 vs. 8 of 20 and 4 of 20 patients), Actuarial rates of acute hepatitis and chro nic active hepatitis were 77% and 59%, respectively, 3 years after tra nsplantation in patients infected by type Ib and 40% (P = 0.008) and 2 2% (P = 0.004) in those infected by other types, There was no statisti cal relation between the level of MCV viremia and HCV genotypes both b efore and after transplantation, in contrast, after transplantation, s erum HCV RNA Values were: significantly increased in patients who deve loped hepatitis after transplantation. Conclusions: This study provide s direct evidence that HCV Ib is associated with more aggressive recur rent liver disease than other genotypes.