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RELATIONSHIP BETWEEN HEPATITIS C GENOTYPE AND SEVERITY OF RECURRENT HEPATITIS C AFTER LIVER TRANSPLANTATION1,2

 

作者: Gordon3,4 Fredric,   Poterucha3 John,   Germer5 Jeff,   Zein3 Nizar,   Batts5 Kenneth,   Gross3 John,   Wiesner3 Russell,   Persing5 David,  

 

期刊: Transplantation  (OVID Available online 1997)
卷期: Volume 63, issue 10  

页码: 1419-1423

 

ISSN:0041-1337

 

年代: 1997

 

出版商: OVID

 

数据来源: OVID

 

摘要:

Background.Recurrence of hepatitis C virus (HCV) infection after liver transplantation is universal, but the relationship between hepatitis C genotype and posttransplant outcome has been controversial. The aim of this study was to assess the relationship between hepatitis C genotype on posttransplant frequency of recurrent hepatitis, histologic severity of recurrence, and progression to cirrhosis.Methods.We studied 42 HCV RNA positive patients who received transplants between 1985 and 1994. Sera were tested for HCV RNA and protocol liver biopsies were in obtained the posttransplant period. Biopsies were scored according to the histologic activity index (HAI) and staged in a blinded fashion.Results.The distribution of hepatitis C genotypes distribution was as follows: 1a, 19 (45%); 1b, 17 (40%); 2b, 3 (7%); and 1 each of 2a, 3a, and 4a. There was histologic evidence of hepatitis in 38 of 42 (90.4%) of patients. Hepatitis C was mild, moderate, or severe (HAI>3) in 38% of grafts and minimal (HAI 0-3) in 62%. Overall HAI scores and histologic stage were higher in the genotype 1b group. Six of 17 (35%) genotype 1b patients had cirrhosis compared with 2 of 25 (8%) in the non-1b genotype group.Conclusions.(1) Histologic evidence of recurrent hepatitis C is seen in 90% of liver allografts; (2) Histologic hepatitis C recurs with similar frequency in genotype 1b and non-1b recipients; (3) Genotype 1b is associated with more severe histologic disease recurrence than non-1b genotypes; (4) Genotype 1b appears to be associated with a higher degree of posttransplant fibrosis and cirrhosis than non-1b genotypes.

 



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