LIVER-FUNCTION TESTS OF RECIPIENTS WITH HEPATITIS-C VIRUS-INFECTION AFTER BONE-MARROW TRANSPLANTATION

We used the polymerase chain reaction (PCR) to determine the presence of hepatitis C virus (HCV)-RNA in serum samples obtained from 19 patie nts with leukaemia or severe aplastic anaemia and investigated the cor relation between HCV status and the results of liver function tests af ter bone marrow transplantation. PCR analysis of serum samples obtaine d before transplant showed that 10 of 18 patients were HCV-RNA-positiv e; 5 of these patients had developed acute post-transfusion hepatitis 1-11 months before transplant. An additional patient was HCV-RNA-posit ive on post-transplant day 62. Eight HCV-RNA-positive patients had pre -transplant GPT levels above the upper limit of normal. In these patie nts the GPT decreased significantly from a median of 104 IU/l (54-822 IU/l) pre-transplant to 23 IU/l (15-56 IU/l) on post-transplant days 8 -12. In 9 of 11 HCV-RNA-positive patients, the GPT increased transient ly from days 40 to 50 and again increased after day 100. Two of these patients died from hepatic failure; the GPT levels normalised in 3 pat ients after day 300 but continued to fluctuate in 4 patients. In the r emaining 2 HCV-RNA-positive patients, the GPT remained close to the no rmal range throughout the follow-up period. Three HCV-RNA-positive pat ients became HCV-RNA-negative after 1-3 years. In these patients, the GPT remained normal for > 3 Sears after day 300. In the 8 patients who se pre-transplant serum samples were HCV-RNA-negative, the GPT remaine d below 200 IU/l for over 1 year after transplant, despite the presenc e of chronic GVHD in 4 of these patients. Our findings suggest that GP T levels after transplant in patients with HCV infection are strongly influenced by the immunocompetence of patients.