Recurrence of hepatitis c virus infection after orthotopic liver transplantation: Role of genotypes

In this study, we evaluated the correlation beetwen alanine aminotrasferase levels and hepatitis C virus genotypes in liver transplant patients. We st udied 18 patients who had undergone orthotopic liver transplantation becaus e of end-stage cirrhosis (n=9) or hepatocellular carcinoma (n=9) hepatitis C virus related. Serum HCV-RNA testing was performed monthly on all the 18 series of serum s amples from the first week after liver transplant until the end of the foll ow up, this period ranging from 1 to 39 months. After liver transplantation, serum HCV-RNA was detected in 14 patients (78% ). Of the 8 patients infected with subtype Ib, 1 remained asymptomatic, 2 d eveloped acute liver failure and 5 developed chronic hepatitis. In patients infected with types 1a (Choo et al., 1989), 2a (Choo ct al., 19 89), with a mixed infection 1b/3 (Kuo et al., 1989) or with an undetermined genotype, significant laboratory abnormalities were not observed. Recurrence of hepatitis C virus infection after liver transplantation is co mmon, and recurrent hepatitis occurs in 50% of cases. Genotype 1b appears t o be associated with a higher rate of recurrent hepatitis, compared to othe r, genotypes.