LONG-TERM EFFECTS OF HEPATITIS-C VIRUS-INFECTION IN ALLOGENEIC BONE-MARROW TRANSPLANT RECIPIENTS

A total of 161 patients transplanted between 1978 and 1991 and who had survived at least 2 years after allogeneic bone marrow transplantatio n (BMT) were studied. Of 161 surviving patients, 28 (17.4%) were posit ive for hepatitis C virus (HCV) either by serology or polymerase chain reaction (PCR). Twenty-five patients were positive for HCV RNA by PCR , and 26 of the 28 patients had HCV antibodies detected by enzyme-link ed immunosorbent assay (ELISA). The median follow-up time of HCV-posit ive patients was 6.1 years (range, 2.8 to 14.0 years). There was no di fference in the frequency or degree of liver dysfunction between patie nts who were PCR-positive or -negative before BMT. Six patients develo ped severe liver dysfunction after BMT, and five of these patients did so after discontinuation or tapering of immunosuppression. No patient has developed liver failure. Serum transaminases were abnormal at the time of last follow up in 19 of 28 (68%) patients. Fifteen patients h ave had liver biopsies. No biopsy showed development of cirrhosis. We conclude that HCV is not a major contributing factor to morbidity and mortality during the first 5 to 10 years after allogeneic BMT. (C) 199 5 by The American Society of Hematology.