IGM ANTI-HEPATITIS-C VIRUS CORE ANTIBODIES AS MARKER OF RECURRENT HEPATITIS-C AFTER LIVER-TRANSPLANTATION

The differential diagnosis of recurrent hepatitis C following orthotop ic liver transplantation (OLT) may be difficult. We evaluated the diag nostic significance of IgM anti-hepatitis C virus (anti-HCV) core anti bodies in 27 patients undergoing OLT because of HCV-associated cirrhos is. Serial serum samples collected before and after OLT were tested fo r the presence of IgM anti-HCV core antibodies. Results were compared with the histological evidence of liver damage, the presence, level, a nd genotype of serum HCV RNA and the degree of immunosuppression. All patients underwent recurrent HCV infection. Recurrent hepatitis was di agnosed histologically in 21 patients an average of 48 weeks after OLT (range 2-209 weeks): 18 had persistence or (re)appearance of the IgM anti-HCV core after OLT, one lost the IgM anti-HCV core after OLT, and two never secreted IgM anti-HCV core either before or after OLT. The remaining six patients did not develop recurrent hepatitis after a fol low-up of 44-241 weeks from OLT; in these patients, IgM anti-HCV core either disappeared (1 case) or decreased (1 case) after OLT or were pe rsistently negative throughout the study (4 cases). Thus, 18/21 patien ts with recurrent hepatitis, but only one of six without recurrent hep atitis, secreted IgM anti-HCV core after OLT (P < 0.05). The IgM anti- HCV core levels were not correlated with the level or genotype of seru m HCV RNA or the degree of immunosuppression. In conclusion, secretion of IgM anti-HCV core antibodies after OLT seems associated with recur rence of HCV-associated liver disease and may have diagnostic signific ance. J. Med. Virol. 56:224-229, 1998. (C) 1998 Wiley-Liss, Inc.