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Outcome of De Novo hepatitis C virus infection in heart transplant recipients
Author(s) -
Ong Janus P.,
Barnes David S.,
Younossi Zobair M.,
Gramlich Terry,
YenLieberman Belinda,
Goormastic Marlene,
Sheffield Cedric,
Hoercher Kathy,
Starling Randall,
Young James,
Smedira Nicholas,
McCarthy Patrick
Publication year - 1999
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510300519
Subject(s) - medicine , viremia , hepatitis c virus , gastroenterology , liver transplantation , immunology , antibody , hepatitis c , liver disease , heart transplantation , hepacivirus , transplantation , virus
The outcome of de novo hepatitis C virus (HCV) infection in heart transplant recipients of HCV‐antibody positive organs is not known. The aim of the study was to determine the short‐term outcome of de novo HCV infection in recipients of HCV‐positive donor organs. HCV‐antibody negative recipients of HCV‐antibody positive hearts were identified from January 1, 1991 to February 28, 1998. Control patients matched for year of transplantation were also identified. Twenty‐eight patients (22 males, mean age of 56 ± 11 SD) received hearts from HCV‐antibody–positive donors. The control group was similar to the patients in all clinical and demographic aspects. Twenty‐three patients had detectable viremia by reverse‐transcription polymerase chain reaction (RT‐PCR). Of these 23 patients with de novo HCV infection, 7 (30%) developed HCV‐related liver disease. Three patients (13%) had chronic hepatitis and 4 patients (17%) developed severe acute cholestatic hepatitis (ACH). Mycophenolate mofetil (MMF) use ( P = .04) and high viral load at onset of acute liver disease ( P = .02) were associated with ACH. Overall survival was similar between patients with de novo HCV infection and controls ( P = .20). Development of ACH ( P = .02) and MMF use ( P = .0009) were associated with decreased survival in patients with de novo HCV infection. The present study showed that survival of patients with de novo HCV infection was similar to a matched control group. HCV‐related severe ACH is associated with a poor short‐term outcome in patients with de novo HCV infection. MMF use may be associated with a higher incidence of HCV‐related severe ACH and a poor short‐term outcome.