QUANTITATION OF HEPATITIS-C VIRUS-RNA IN LIVER-TRANSPLANT RECIPIENTS

Background/Aims: Hepatitis C virus (HCV) infection is common in liver transplant recipients, yet the effects of immunosuppression on HCV RNA levels and the relationship of HCV RNA levels to hepatic damage have not been studied. Methods: To explore these issues, we measured HCV RN A in serum by polymerase chain reaction amplification and branched DNA assay from 100 HCV-infected patients undergoing liver transplantation . Results: Mean posttransplant levels were 16-fold higher than pretran splant values (7,935,000 and 496,000 Eq/mL, respectively; n = 65; P < 0.0001). Patients with high pretransplant levels had higher mean postt ransplant levels than those with low pretransplant levels (17,119,000 and 6,504,000 Eq/mL, respectively; P = 0.064). Posttransplant levels w ere similar in patients with recurrent and acquired infection and were independent of time of sampling. Fifty percent of patients with HCV i nfection had normal liver biopsy specimens, and there was no strong re lationship between level of viremia and degree of hepatic damage. Conc lusions: HCV RNA levels increase markedly following liver transplantat ion. The frequent finding of viremia in the absence of histological he patitis suggests that a ''carrier state'' is common. Absence of allogr aft damage in some (despite high levels of viral RNA) suggests that in immunosuppressed patients, HCV infection may be tolerated without dir ect hepatic damage.