By Cheryl Lathrop
BOSTON -- November 2, 2009 -- Viral load is an important factor and can predict the outcome of patients with hepatitis C virus (HCV) after liver transplantation, for both the development of the different types of recurrent HCV and patient survival, researchers stated here at the Liver Meeting 2009, the 60th Annual Meeting of the American Association for the Study of Liver Diseases (AASLD).
Ivo Graziadei, Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria, and colleagues reported the findings from their study in a poster session here on October 31.
After liver transplant, recurrent HCV infection is ubiquitous and leads to graft loss and re-transplantation for 10% to 20% of liver transplant recipients. Donor, recipient, and viral parameters are the risk factors associated with HCV recurrence.
As there has been conflicting data reported about the viral load and the severity of recurrent HCV disease, the aim of this study was to analyse the impact of the viral load upon the severity of the recurrent HCV infection.
The study included data from 129 patients who received liver transplants due to HCV cirrhosis between 1980 and 2006 at the Medical University of Innsbruck and, who survived more than 6 months, and had histologically proven recurrent HCV infection.
Viral load was measured at week 2, and at months 3, 6, and 12 post-transplant (using the bDNA HCV RNA 3.0 assay by Bayer Diagnostics). There was a mean overall follow-up of 6.1 +- 3.6 years. Annual liver biopsies began in 2000; before that, biopsies were performed only in patients with elevated serum transaminases.
The majority of patients (81.4%) had no, or only mild to moderate HCV recurrence; 18.6% developed either a cholestatic type of recurrence (8.6%) or a rapid progression to advanced fibrosis/cirrhosis (9.1%).
Early viraemia (HCV RNA levels >6.0 log10 IU/mL) at week 2 were highly predictive for the cholestatic type of recurrence and poor patient survival. High viral loads (>6.5 log10 IU/mL) at month 3 were associated with recurrent cirrhosis of the liver allograft.
[Presentation Title: Viral Load Predicts Outcome of Hepatitis C Patients After Liver Transplantation. Abstract 516]
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