Related Experiment Videos
Hepatitis C virus infection is a risk factor for liver failure from veno-occlusive disease after bone marrow
N Frickhofen1, M Wiesneth, C Jainta
1Department of Medicine III, University of Ulm, Germany.
Insights
Hepatitis C virus (HCV) infection significantly increases the risk of lethal veno-occlusive disease (VOD) after bone marrow transplantation (BMT). Pre-existing HCV infection in BMT patients is strongly associated with fatal VOD outcomes.
Area of Science:
- Hepatology
- Virology
- Transplantation Medicine
Background:
- Hepatitis C virus (HCV) infection is a global health concern.
- Bone marrow transplantation (BMT) is a critical treatment for various hematologic disorders.
- The impact of HCV on liver disease post-BMT requires further elucidation.
Purpose of the Study:
- To retrospectively evaluate the contribution of HCV infection to liver disease following BMT.
- To assess the relationship between HCV infection and the development of veno-occlusive disease (VOD) post-BMT.
Main Methods:
- Retrospective analysis of 61 patients undergoing BMT.
- Analysis of HCV genome and antibodies in patient sera collected pre- and post-BMT.
- Comparison of VOD incidence and outcomes between HCV-infected and non-infected patients.
Main Results:
- Six patients (9.8%) had pre-existing HCV infection; three (4.9%) acquired HCV during or shortly after BMT.
- All six patients with pre-BMT HCV infection died within 10 weeks, with 83% succumbing to VOD.
- HCV-infected patients had a significantly higher risk of VOD (83% vs. 17%, P < .005) compared to uninfected patients.
- Increased HCV replication correlated with VOD development.
- Acquired HCV infection post-BMT resulted in mild acute hepatitis C, progressing to chronic hepatitis in one long-term survivor.
Conclusions:
- HCV infection, particularly pre-existing, poses a substantial risk for lethal VOD after BMT.
- HCV-infected patients undergoing BMT require careful monitoring for liver complications and VOD.
- HCV screening and management strategies may be crucial for improving BMT outcomes.
Abstract:
The contribution of hepatitis C virus (HCV) infection to liver disease after bone marrow transplantation (BMT) was retrospectively evaluated in 61 patients treated with BMT. HCV genome, as well as antibodies to HCV, was analyzed in sera collected before and serially after BMT. Six patients had been infected with HCV before BMT and three patients acquired the infection during or shortly after BMT. All patients infected before BMT died within 10 weeks after transplantation. Five of these six patients (83%) died of veno-occlusive disease (VOD), compared with nine of 52 patients (17%) not infected with HCV (P < .005). Risk factors for VOD other than HCV were not more prevalent in these patients compared with uninfected patients. Parallel to the development of VOD, replication of HCV increased, as demonstrated by rising concentrations of viral RNA in serum. HCV infection acquired during or after BMT caused only mild acute hepatitis C, which progressed to chronic hepatitis C in one patient surviving 10 years after BMT. These data suggest that patients with liver disease caused by HCV infection are at high risk of developing lethal VOD after BMT.