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Hepatitis C virus genotypes and liver disease in patients undergoing allogeneic bone marrow transplantation
A Locasciulli1, M Testa, P Pontisso
1Clinica Pediatrica Università di Milano, Divisione di Ematologia Pediatrica, Ospedale S Gerardo Monza (MI), Italy.
Insights
This study investigated Hepatitis C virus (HCV) genotypes in patients after allogeneic BMT. No clear link was found between HCV genotype and the severity of liver disease post-transplant.
Area of Science:
- Hepatology
- Transplant Immunology
- Virology
Background:
- Hepatitis C virus (HCV) infection poses a significant risk for liver disease (LD) post-hematopoietic stem cell transplantation.
- Outcomes of HCV infection vary widely among patients undergoing allogeneic BMT, with liver failure (LF) rates differing dramatically between transplant centers.
Purpose of the Study:
- To investigate whether specific HCV genotypes correlate with the varying severity of post-transplant liver disease.
- To determine if HCV genotype influences the type and outcome of liver complications after allogeneic BMT.
Main Methods:
- Collected sera from 57 HCV-infected patients (pre- and post-BMT) across four European BMT units.
- Classified patients based on liver disease status: liver failure (LF), acute hepatitis (AH), chronic hepatitis (CH), or no liver disease (LD).
- Identified HCV genotypes using 5'UTR amplification and type-specific oligonucleotide probes.
Main Results:
- HCV genotype 1 was the most prevalent (60%), followed by genotype 2 (26%).
- In the LF group, genotype 1 was identified in 10/19 patients, with earlier median timing of LF (45 days) compared to other genotypes (68 days).
- Genotype 1 was also found in patients with no liver disease, indicating no consistent correlation with disease severity.
Conclusions:
- The study found no evident correlation between specific HCV genotypes and the type or severity of post-transplant liver disease.
- HCV genotype does not appear to be a determining factor for liver complications following allogeneic BMT.
Abstract:
Hepatitis C virus (HCV) genotypes were investigated in 57 HCV-infected patients undergoing allogeneic BMT at four European BMT units where death resulting from liver failure (LF) in HCV-infected patients varied from < 1% to > 80%. The aim of the study was to determine whether differing HCV genotypes could account for the different severity of post-transplant liver disease (LD). Sera from patients with pre (n = 22) or post-BMT (n = 35) HCV infection were collected from Italy (Genova, Monza), Sweden (Huddinge) and Germany (Ulm). Patients were grouped as follows: LF: 19/57; acute hepatitis (AH): 10/57 or chronic hepatitis (CH): 22/57; no liver disease (LD): 6/57. HCV genotypes were identified by hybridisation of the 5'UTR amplified products with type-specific oligonucleotides probes according to Simmonds (Hepatology 1994; 19: 1321-1324). Genotype HCV 1 was identified in 34 patients (60%), HCV 2 in 15 (26%), HCV 3 in three (5%), mixed infection in three (5%) and undefined in two (3.5%). In the LF group HCV 1 was identified in 10/19 and other genotypes in 9/19. Median timing of LF was earlier in patients infected with HCV 1 compared to other genotypes (45 and 68 days, respectively), largely due to the cause of LF; death from veno-occlusive disease (VOD) and hepatitis occurred at 30 and 68 days post-BMT, respectively. Genotype 1 was also identified in cases with no LD. These data indicate that there was no evident correlation between HCV genotype and type or severity of post-transplant liver disease.