Anti-hepatitis C virus core IgM antibodies correlate with hepatitis C recurrence and its severity in liver transplant patients

Background-The significance of immunoglobulin (Ig) M antibody to hepatitis C virus (HCV) core antigen was studied in 60 patients with HCV infection af ter orthotopic Liver transplantation (OLT) diagnosed by polymerase chain re action. Methods-Patients were followed up for a mean of 28 months after transplanta tion. Sera collected three months before transplantation, and one and 12 mo nths after transplantation were analysed for anti-HCV core IgM (MCV-IgM EIA 2.0 assay). After OLT protocol biopsies, procedures were performed routine ly every six months. Semiquantitative histopathological assessment of allog raft hepatitis was performed using Knodell's score. The results were correl ated with clinical features, liver histology findings, and virological feat ures, such as genotype and viraemic levels assessed by a branched DNA assay . Results-One year after liver transplantation, 29/60 (48%) patients had chro nic hepatitis on graft biopsy. The presence of anti-HCV core IgM one month (p=0.004) and 12 months (p=0.003) after OLT was positively correlated with recurrence of chronic hepatitis. The positive predictive value of anti-HCV core IgM detected one month after transplantation was 0.88. A significant r elationship was observed between severity of graft disease and presence of anti-HCV core IgM 12 months after transplantation. The mean Knodell score w as 8.9 in anti-HCV core IgM positive patients compared with 3.6 in those wh o were anti-HCV core IgM negative (p=0.001). The presence of IgM anti-HCV d id not correlate with serum HCV RNA level or HCV genotype. Conclusion-We confirm that the presence of anti-HCV core IgM after OLT is a marker of HCV induced graft damage. The recurrence and severity of MCV hep atitis in patients undergoing OLT for HCV cirrhosis is related to the prese nce of anti-HCV core IgM after Liver transplantation. These findings have d iagnostic relevance and confirm that measurement of IgM anti-HCV core may h elp to better monitor the treatment of HCV recurrence after transplantation .