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Severe Hepatitis C Recurrence as a Risk Factor for Opportunistic Infections in Liver Transplant Recipients
M Bodro1, G Sanclemente1, G Crespo2
1Infectious Diseases Department, Hospital Clínic-IDIBAPS-CIBERHED, University of Barcelona, Barcelona, Spain.
Transplantation Proceedings
|June 9, 2018
Summary
Severe hepatitis C virus (HCV) recurrence after liver transplant increases the risk of opportunistic infections (OI), particularly cytomegalovirus and fungal infections. Vigilance for OI is crucial in these patients.
Area of Science:
- Hepatology
- Transplant Surgery
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) recurrence is a significant concern in liver transplant recipients.
- Severe recurrence (SR) may impact post-transplant outcomes and infection risk.
Purpose of the Study:
- To determine clinical characteristics, OI frequency, and outcomes in liver transplant recipients with severe HCV recurrence.
- To evaluate HCV recurrence as a risk factor for developing opportunistic infections.
Main Methods:
- Retrospective observational study of liver transplant recipients from 2003-2012.
- Patients with HCV liver disease were selected and monitored for infections.
- Classification based on the presence of severe HCV recurrence.
Main Results:
- 370 patients with chronic HCV underwent liver transplantation; 49% had severe recurrence (SR).
- Patients with SR had higher rates of opportunistic infections (OI), especially cytomegalovirus (CMV) and fungal infections (33% vs 13%).
- Acute allograft rejection, donor age ≥60, and SR were independently associated with OI development.
Conclusions:
- Maintain a high index of suspicion for OI in liver transplant recipients with severe HCV recurrence.
- Consider active surveillance for CMV infection and prophylactic strategies against OI.
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