Hepatitis C virus infection in patients undergoing allogeneic bone marrow transplantation

Transplantation. 1991 Aug;52(2):315-8. doi: 10.1097/00007890-199108000-00025.

Abstract

Antibody to the recently identified hepatitis C virus was investigated in sera of 128 patients treated with allogeneic bone marrow transplantation, to determine the prevalence of HCV infection and its role in post-transplant liver complications. The overall prevalence of anti-HCV positivity was 28.6% (38/128 patients). The presence of pretransplant anti-HCV positivity (in 10/35 tested patients) did not seem to predict a more severe liver disease. In fact 8/10 anti-HCV+ and 15/25 anti-HCV- patients had elevated transaminases at BMT, and posttransplant liver failure (due to VOD or subacute hepatitis), and post-BMT rises in transaminases occurred regardless of anti-HCV serology (P = 0.6 and 0.2, respectively). In patients tested for anti-HCV after BMT (n = 128), only two (one anti-HCV+ and one anti-HCV-) experienced VOD; the number of patients in whom liver failure contributed to death was comparable in anti-HCV-positive and anti-HCV- negative patients (P = 0.4). Among 17 patients with documented posttransplant seroconversion (from anti-HCV- to anti-HCV+) the appearance of anti-HCV was concomitant with hepatitis exacerbation in 9 (53%). Histologic changes demonstrated a more severe liver damage in anti-HCV+ patients: a chronic hepatitis was diagnosed in 9/11 anti-HCV+ versus 1/7 anti-HCV- cases. Based on these observations, we conclude that hepatitis C virus has a role in liver disease in such patients, although its evaluation by the anti-HCV test is still of limited accuracy, due to low sensitivity and incomplete specificity.

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation / immunology*
  • Child
  • Child, Preschool
  • Female
  • Hepacivirus / immunology*
  • Hepatitis Antibodies / analysis
  • Hepatitis Antibodies / immunology
  • Hepatitis C / blood
  • Hepatitis C / epidemiology*
  • Hepatitis C / immunology
  • Hepatitis C Antibodies
  • Humans
  • Infant
  • Liver / cytology
  • Liver Diseases / blood
  • Liver Diseases / epidemiology
  • Liver Diseases / immunology
  • Male
  • Middle Aged
  • Prevalence

Substances

  • Hepatitis Antibodies
  • Hepatitis C Antibodies