Hepatitis C status of heart transplant recipients

Department of Gastroenterology, University of Padua, Italy.
Clinical Transplantation (Impact Factor: 1.52). 03/1998; 12(1):5-10.
Source: PubMed


The records of 155 consecutive patients who underwent successful heart transplantation (HTx) were reviewed to document the incidence of hepatitis C (HCV) infection. One patient was HCV RNA positive pre-HTx, and 12 patients (8%) developed transient or permanent HCV positivity post-HTx. HCV RNA positivity was associated with biochemical features of liver injury. Liver biopsy was performed in 8, and demonstrated features of chronic hepatitis in all. Two patients died of chronic liver failure at 50 and 56 months post-HTx, respectively. Interferon therapy was given to three patients, two of whom converted to HCV negativity. This study suggests that HCV infection is more common than previously anticipated in HTx patients, and varies from a mild transient condition to a fatal chronic liver failure.

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    ABSTRACT: Heart transplant (HTx) recipients risk acquiring hepatotropic viral infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV), and the impact of these infections on post-HTx survival remains unclear. The aim of the present study was to define the prevalence, clinical features, and natural history of HBV and HCV infections in a cohort of HTx recipients. We retrospectively studied 360 consecutive patients who had undergone HTx. Clinical picture, hepatic injury indexes, and HBV/HCV viral serology were followed post-transplant. During follow-up (average, 8 +/- 3.1 years), 49 (16.5%) of the HTx recipients tested positive for at least 1 of the 2 viruses (3.1% HBV, 12% HCV, 0.5% concomitant infection). The prevalence of HCV infection in heart transplant recipients transplanted before and after 1990 was 28% and 4.2%, respectively, the latter being markedly lower (p < 0.001) than in earlier series of HTx recipients and much lower than expected in the age- and sex-matched general population. All HBV-positive and 58% of HCV-positive recipients developed chronic liver disease. Sixteen percent of patients developed cirrhosis during follow-up, and 8% died of end-stage liver disease. The prevalence of HBV and HCV in a large population of HTx recipients is not very different from that reported in the general population. Active viral replication of HBV and an aggressive natural history of both infections are seen in HTx recipients, however. The low prevalence of HBV- and HCV-related infection in recent series probably reflects current viral screening and vaccination policies.
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    ABSTRACT: Hepatitis C virus (HCV) infection is a worldwide epidemic that is causing substantial morbidity and mortality in the general population. Due to inherent risks of HCV transmission through blood and tissue, solid organ and bone marrow transplant recipients have a higher incidence of HCV infection than that of the general population, especially in those transplanted prior to widespread screening for HCV in the early 1990s. The impact of HCV infection in liver transplantation is well characterized, but is less frequently discussed in kidney, heart, lung, and bone marrow transplantation. This article provides a comprehensive and current review of the literature with regard to the epidemiology, pathogenesis, outcome, and treatment of HCV infection in the setting of kidney, heart, lung, and bone marrow transplantation.
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