Early viral load and recipient interleukin-28B rs12979860 genotype are predictors of the progression of hepatitis C after liver transplantation

Liver Transpl. 2012 Jun;18(6):671-9. doi: 10.1002/lt.23402.

Abstract

There have been few detailed studies of viral kinetics after liver transplantation (LT), and conflicting data have been reported on viral loads and the severity of recurrent hepatitis C virus (HCV) disease. This long-term study aimed to examine (1) the impact of HCV RNA levels at specific points in time within the first year and (2) the influence of interleukin-28B (IL-28B) genotypes on patient outcomes and the severity of recurrent HCV disease. The viral loads were measured 2, 4, 12, 24, and 48 weeks after LT, and the recipient/donor IL-28B genotypes of 164 patients were determined. A Cox regression analysis showed that the viral load at week 2 was an independent negative predictor of recipient outcomes. A week 2 viral load ≥ 6.0 log(10) IU/mL was significantly associated with reduced patient survival. After a mean follow-up of 6.5 years, 21 of 164 patients (12.8%) developed a cholestatic type of HCV recurrence and/or rapidly progressed to cirrhosis within 1 year. A multivariate binary regression analysis showed that HCV viremia at week 2 and a non-C/C recipient IL-28B genotype were independent risk factors for cholestatic recurrent HCV. No predictive factors could be found for the occurrence of recurrent liver cirrhosis 5 and 10 years after LT. Our study shows that the HCV RNA level at week 2 and the recipient IL-28B genotype are independent, statistically significant risk factors for post-LT cholestatic HCV, and it emphasizes the importance of viral load monitoring and IL-28B genotyping for identifying HCV recipients at risk for severe HCV recurrence.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • Disease Progression
  • Female
  • Genotype
  • Graft Survival / immunology
  • Hepatitis C, Chronic / drug therapy
  • Hepatitis C, Chronic / genetics*
  • Hepatitis C, Chronic / mortality
  • Humans
  • Interferons
  • Interleukins / genetics*
  • Interleukins / immunology*
  • Liver Transplantation / immunology*
  • Liver Transplantation / mortality
  • Male
  • Middle Aged
  • Postoperative Complications / genetics*
  • Postoperative Complications / mortality
  • Postoperative Complications / virology
  • Predictive Value of Tests
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • Viral Load / immunology*
  • Young Adult

Substances

  • Antiviral Agents
  • IFNL3 protein, human
  • Interleukins
  • Interferons