Recurrent and new hepatitis C virus infection after liver transplantation

James E. Evermart, Yuling Wei, Heather Eng, Michael R. Charlton, David H. Persing, Russell H. Wiesner, Jeffrey J. Germer, John R. Lake, Rowen K Zetterman, Jay H. Hoofnagle

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

Chronic infection with the hepatitis C virus (HCV) is the most common reason for liver transplantation. We examined the results of laboratory tests for HCV on a cohort of patients who received a liver transplant between 1990 and 1994 at three large centers. Seven hundred twenty-two recipients and 604 donors were tested for antibody to HCV (anti-HCV) using a second-generation enzyme-linked immunoassay (EIA-2), followed by recombinant immunoblot (RIBA- 2) and HCV RNA confirmation by reverse-transcription polymerase chain reaction (RT-PCR) (with genotyping and viral quantification). Diagnosis of posttransplantation infection required detection of serum HCV RNA that could be genotyped by sequencing or was repeatedly positive despite being unsequenceable. Twenty-five percent of transplantation candidates were seropositive for anti-HCV. Approximately 86% of anti-HCV-positive, 93% of RIBApositive, and 97% of HCV RNA-positive candidates developed infection after transplantation. Pretransplantation HCV RNA was superior to RIBA-2 for predicting posttransplantation infection. Whereas HCV genotype was identified in nearly all candidates and changed little after transplantation, serum viral levels rose markedly after transplantation. Fifteen donors were either anti-HCV- or HCV RNA-positive. Recipients of grafts from donors with HCV RNA all developed infection, whereas infection was not detected in recipients of grafts from donors with anti-HCV but without detectable HCV RNA. The rate of new infection fell significantly (P = .02) after the introduction of EIA-2 screening of blood. Donor and candidate markers for HCV predict posttransplantation infection.

Original languageEnglish (US)
Pages (from-to)1220-1226
Number of pages7
JournalHepatology
Volume29
Issue number4
StatePublished - Apr 20 1999

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Virus Diseases
Hepacivirus
Liver Transplantation
Hepatitis C Antibodies
RNA
Infection
Tissue Donors
Transplantation
Transplants
Serum
Immunoenzyme Techniques
Reverse Transcription
Genotype
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Hepatology

Cite this

Evermart, J. E., Wei, Y., Eng, H., Charlton, M. R., Persing, D. H., Wiesner, R. H., ... Hoofnagle, J. H. (1999). Recurrent and new hepatitis C virus infection after liver transplantation. Hepatology, 29(4), 1220-1226.

Recurrent and new hepatitis C virus infection after liver transplantation. / Evermart, James E.; Wei, Yuling; Eng, Heather; Charlton, Michael R.; Persing, David H.; Wiesner, Russell H.; Germer, Jeffrey J.; Lake, John R.; Zetterman, Rowen K; Hoofnagle, Jay H.

In: Hepatology, Vol. 29, No. 4, 20.04.1999, p. 1220-1226.

Research output: Contribution to journalArticle

Evermart, JE, Wei, Y, Eng, H, Charlton, MR, Persing, DH, Wiesner, RH, Germer, JJ, Lake, JR, Zetterman, RK & Hoofnagle, JH 1999, 'Recurrent and new hepatitis C virus infection after liver transplantation', Hepatology, vol. 29, no. 4, pp. 1220-1226.
Evermart JE, Wei Y, Eng H, Charlton MR, Persing DH, Wiesner RH et al. Recurrent and new hepatitis C virus infection after liver transplantation. Hepatology. 1999 Apr 20;29(4):1220-1226.
Evermart, James E. ; Wei, Yuling ; Eng, Heather ; Charlton, Michael R. ; Persing, David H. ; Wiesner, Russell H. ; Germer, Jeffrey J. ; Lake, John R. ; Zetterman, Rowen K ; Hoofnagle, Jay H. / Recurrent and new hepatitis C virus infection after liver transplantation. In: Hepatology. 1999 ; Vol. 29, No. 4. pp. 1220-1226.
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