Incidence and outcome of hepatitis C virus infection after liver transplantation

Abstract The objective of this study was to determine the incidence and outcome of hepatitis C virus (HCV) infection after liver transplantation (OLT). Fifty‐two transplanted patients were studied. Serum samples were examined for antibodies to HCV (anti‐HCV) and HCV‐RNA by PCR, before and after OLT. Patients were distributed into two groups: group 1 consisted of 24 patients (pretransplant anti‐HCV positive) and group 2 consisted of 28 patients (pretransplant anti‐HCV negative). One year after OLT, HCV‐infected patients were evaluated by liver biopsy. HCV‐RNA was detected in 28 of the 52 (53.9%) patients after OLT. Twenty‐two patients in group 1 (96%) were reinfected. In group 2, acquired HCV infection was detected in six (21.4%) patients. At 6 and 12 months, one and five of six patients had seroconverted, respectively. Liver biopsy in 23 HCV‐infected patients showed chronic hepatitis in 18 (78%) cases (2, chronic persistent hepatitis; 3, chronic lobular hepatitis and 13, chronic active hepatitis). Fourteen of the 23 (60.8 %) patients were asymptomatic. Most symptomatic patients had chronic hepatitis with cholestasis. Overall, 18 of 20 cases of chronic hepatitis diagnosed in OLT recipients were HCV related. Mortality beyond 6 months after OLT was slightly higher in the HCV‐infected group (P= 0.055). In conclusion, HCV reinfection is almost universal. Acquired HCV infection post‐OLT is frequent. HCV‐infected patients frequently develop chronic hepatitis. Most chronic hepatitis after transplantation are HCV related. Copyright © 1994, Wiley Blackwell. All rights reserved