The Influence of Viral Genotypes and Rejection Episodes on the Recurrence of Hepatitis C After Liver Transplantation

Abstract

Our findings showed the genotype 1b to result in a higher recurrence rate after OLT. On the other hand, rejection episodes were associated with a more rapid progression to graft cirrhosis.

Patterns of recurrent hepatitis C after liver transplantation in a recent cohort of patients

“…As expected, high viral load and HCV genotype 1 was associated with progressive hepatitis, both typical R-HCV and AIH-like [13]. We were unable to confirm the adverse outcome with genotype 1B, also probably due to a low number of cases [14,19].…”

“…Of these 61 with hepatitis, 24 cases (39.3%), about a quarter (26%) of the entire study group (n = 92) developed histologically confirmed progressive fibrosis over a median follow-up period of 1447 days (range, 673-2231 days). As reported in the literature, there are several factors that are associated with progressive hepatitis after LT in HCV patients [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

“…Central venulitis is considered an immune-mediated reaction and is seen in cases of acute and refractory rejection [28]. Multiple steroid pulse therapy for AR and the development of steroid-resistant rejection has previously been reported to negatively impact the outcome of HCV patients [2,14,16]. Perhaps some of these reported cases of brejectionQ might have been AIH-like disorder, a difficult differential diagnostic problem histologically on a single given biopsy [29,30].…”

“…Several host, viral, and donor factors have been associated with poor outcome in post-LT R-HCV [1][2][3][4]6,7,[10][11][12][13][14][15][16][17][18][19][20].…”

Treatment of Genotype 4 Hepatitis C Recurring After Liver Transplantation Using a Combination of Pegylated Interferon Alfa-2a and Ribavirin

“…They reported that patients infected with genotypes 1b and 4 had the worst outcomes, while genotype 2 and 3 patients had less-severe disease recurrence. Sugo et al [19] reported a higher recurrence rate in patients infected with genotype 1b compared to other genotypes, including genotype 4. Others have suggested a worse outcome in genotype 4-infected patients; however, these studies are limited by their small number of genotype 4-infected patients [20].…”