Hepatitis C virus genotypes and quantification of serum hepatitis C RNA inliver transplant recipients - Relationship with histologic outcome of recurrent hepatitis C

The reasons for wide variations in the severity of recurrent hepatitis C af ter liver transplantation are unclear We studied liver transplant recipient s to assess the effect of hepatitis C virus (HCV) genotype and HCV RNA quan tification on histologic progression of recurrent hepatitis C after transpl antation Twenty-five patients underwent transplantation for HCV cirrhosis a nd were followed up with virologic and histologic assessments for a mean of 51 months. HCV genotype was determined by line probe assay. HCV RNA was qu antitated in serum samples by nested polymerase chain reaction. The HCV gen otype 1 was detected in 17 patients and other genotypes in 8. Acute lobular hepatitis developed in 17 patients 162 days posttransplantation an average . Long-term biopsy specimens (mean, 51 months after the date of liver trans plantation; range, 24-86 months) showed chronic hepatitis in 19 patients (m ild, 5; moderate, 9; and severe, 5, 2 with extensive scarring). The serum a lanine aminotransferase level was correlated with hepatocyte necrosis (piec emeal and lobular) but not with portal inflammation or fibrosis. Patients i nfected with genotype 1 had a higher Knodell score, and the 5 patients with severe hepatitis C all were infected with genotype 1. HCV RNA Levels were significantly higher in patients with genotype I than in patients with othe r genotypes, as were the severity of histologic recurrence and levels of vi ral replication.