Source: DGNews  |  Posted 2 years ago

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