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Prevalence of hepatitis C virus antibody in a liver transplantation population
L el-Ashmawy1, T Hassanein, J S Gavaler
1Department of Medicine, Graduate School of Public Health, University of Pittsburgh School of Medicine, Pennsylvania 15261.
Insights
Hepatitis C virus (HCV) is prevalent in liver disease patients awaiting or undergoing liver transplantation (OLTx). Post-OLTx, some patients acquire HCV, highlighting the need for further research into HCV recurrence and acquisition after OLTx.
Area of Science:
- Hepatology
- Virology
- Transplantation Medicine
Background:
- Hepatitis C virus (HCV) serologic assays are crucial for identifying non-A, non-B (NANB) hepatitis causes.
- The prevalence of HCV in end-stage liver disease patients and its behavior post-liver transplantation (OLTx) remain largely unknown.
Purpose of the Study:
- To determine the prevalence of HCV antibodies in patients undergoing OLTx.
- To investigate the rate of HCV acquisition after OLTx.
- To explore the relationship between HCV status and liver disease etiology.
Main Methods:
- Serologic testing for HCV antibodies (anti-HCV) was performed on 372 patients undergoing OLTx.
- Patients were categorized by liver disease etiology prior to OLTx.
- HCV antibody status was assessed pre- and post-OLTx.
Main Results:
- HCV antibody positivity varied significantly by liver disease etiology, with the highest rates in HBV-related liver disease with hepatoma (45.4%) and metabolic liver disease (42.5%).
- Hepatoma patients showed a 26.3% HCV antibody positivity rate.
- 12.2% of HCV antibody-negative patients acquired HCV post-OLTx.
Conclusions:
- HCV is a significant factor in patients with various end-stage liver diseases undergoing OLTx.
- A notable proportion of patients acquire HCV following OLTx, indicating ongoing transmission or susceptibility.
- HCV antibody status may correlate with pre-transplant transaminase levels in specific conditions like cryptogenic cirrhosis.
Abstract:
The development of a serologic assay to detect antibodies directed at an antigen (C-100-3) of the hepatitis C virus (anti-HCV) has been a major breakthrough in the long search for causative agents of non-A, non-B (NANB) hepatitis. The frequency of HCV in those who have end-stage liver disease is not known. Moreover, the rate of recurrence after liver transplantation (OLTx) and the rate of acquisition of new HCV infection as a result of the OLTx experience is as yet unknown. This study was performed in an attempt to answer these questions. The prevalence of HCV in 372 patients undergoing OLTx at the University of Pittsburgh was determined. Those transplanted for HBV-related liver disease with hepatoma had the highest rate of HCV antibody positivity (45.4%) followed by those with metabolic liver disease (42.5%), putative NANB liver disease (41.4%), and cryptogenic cirrhosis (20.9%); those with cholestatic liver disease exhibited the lowest rate (16.2%). HCV antibody was positive in only 26.3% of patients with hepatoma. Of those patients who were negative prior to transplantation, 12.2% acquired HCV antibody post-OLTx. In the putative NANB group, no difference was detected in the AST and ALT prior to transplantation in either the HCV antibody-positive or -negative patients. In patients with cryptogenic cirrhosis, those who were positive for HCV antibody had higher transaminase levels prior to transplantation than did those patients who were HCV antibody negative.