HEPATITIS-C VIRUS-RELATED FIBROSING CHOLESTATIC HEPATITIS AFTER RENAL-TRANSPLANTATION

Fibrosing cholestatic hepatitis is a well-described syndrome in patien ts with immunodeficiency and chronic hepatitis B. It is clinically, bi ologically, and histologically characterized by rapidly progressive he patic failure, a mildly elevated serum aminotransferase level, an exte nsive periportal fibrosis associated with intense cholestasis, mild in flammatory cellular infiltrate, no cirrhosis, and a high hepatocellula r level expression of B viral antigens. This syndrome reflected a dire ct hepatocytopathic injury linked to high intrahepatic viral antigen e xpression. Because the syndrome of fibrosing cholestatic hepatitis has not been described in chronic hepatitis C, we report the first well-c haracterized case in a renal transplant patient with chronic hepatitis C and discuss the clinical and pathogenic implications of such a synd rome in this setting.