Outcome of heart transplantation in patients previously infected with hepatitis C virus

The lack of knowledge about the course of hepatitis C virus infection (HCV) before heart transplantation (HTx) prompted us to describe our experience with 4 such patients who presented with positive HCV serology before surger y. Two experienced non-liver related deaths at 3.5 and 5 years after HTx, a nd none of the patients developed signs of hepatic insufficiency during the follow-up (mean 3.8 years). Tests for HCV antibodies were frequently negat ive, whereas viral RNA was detected in 81% of the measurements, showing tha t virus detection techniques seem to be more sensitive than serology techni ques in detecting HCV infection in this group of patients. Although immunos uppression promotes active HCV replication, it does not seem to change the chronic features of HCV infection during the first years in patients with g ood liver function.