HEPATITIS-C VIRUS-INFECTION AND LIVER-FAILURE IN PATIENTS UNDERGOING ALLOGENEIC BONE-MARROW TRANSPLANTATION

The role of hepatitis C virus (HCV) infection in severe liver failure (LF) following bone marrow transplantation is still uncertain. We ther efore decided to determine the presence of HCV-RNA in 31 patients who died of severe LF after BMT and in 26 matched BMT controls who did not develop LF, HCV-RNA was identified by polymerase chain reaction and a nti-HCV by second generation enzyme-linked immunoassay and by 4-band r ecombinant immunoblotting assay in serum samples obtained before and a fter BMT, Biochemical and clinical parameters of liver disease were ob tained by reviewing clinical records, LF developed at a median interva l of 80 days (20-570) from transplantation and was clinically assessed as VOD (n = 7), liver GVHD (n = 5) or hepatitis (n = 19), HCV-RNA was detected, respectively, in 15/31 (48%) and in 12/26 (46%) of LF patie nts and controls (P = 0.9). Conversely, the risk of dying of LF was 62 % and 53% (P = 0.5) respectively, for HCV-RNA positive and negative pa tients, Anti-HCV profile did not correlate with viremia, nor with type of liver disease. These findings indicate that, despite a 47% prevale nce of HCV infection in our series, HCV-RNA positivity was neither a p redictor of VOD nor a marker for life-threatening liver disease.