LONG-TERM FOLLOW-UP OF HEPATITIS-C VIRUS (HCV) INFECTION IN LIVER-TRANSPLANT PATIENTS

Chronic hepatitis represents a frequent event after orthotopic liver t ransplantation (OLT). To ascertain the influence of HCV infection on t he clinical and histological, outcome of these patients, we have inves tigated the long-term outcome of 22 patients with end-stage chronic li ver disease undergoing liver transplant focusing the attention on the role of different HCV genotypes in determining recurrence and severity of post-OLT liver disease. For all patients blood samples taken befor e OLT and 3 months, 1, 2 and 3 years after OLT were tested for antiHCV antibodies by two different enzyme-linked immune-assays and by recomb inant immune-blot II and for the presence and type of HCV RNA by neste d PCR (5' untranslated region and core gene primers). Of the 16 pre-OL T antiHCV-positive patients, 14 (87.5%) had recurrence of HCV infectio n while 2 cleared HCV Pre-OLT genotype recurred in 11 of these 14 pati ents (2 genotype I, 8 genotype II - in 1 case associated with genotype III and 1 genotype IV). Of the 6 pre-OLT antiHCV-negative patients, o nly 1 (16.6%) became persistently HCV-infected, with genotypes I and I I. The recurrence of genotype II strictly related with development of severe chronic hepatitis while genotype I and IV were associated with milder forms of liver disease and were more easily cleared.