INFLUENCE OF THE GENOTYPES OF HEPATITIS-C VIRUS ON THE SEVERITY OF RECURRENT LIVER-DISEASE AFTER LIVER-TRANSPLANTATION
INFLUENCE OF THE GENOTYPES OF HEPATITIS-C VIRUS ON THE SEVERITY OF RECURRENT LIVER-DISEASE AFTER LIVER-TRANSPLANTATION
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DOI：
10.1016/0016-5085(95)90207-4
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发表时间：
1995-04-01
期刊：
影响因子：
29.4
通讯作者：
BRECHOT, C
中科院分区：
文献类型：
--
作者：
FERAY, C;GIGOU, M;BRECHOT, C
背景/目标：丙型肝炎病毒（HCV）的几种基因型已通过系统发育分析确定，但其临床相关性仍然难以捉摸，肝移植治疗HCV相关肝硬化为这一问题的前瞻性研究提供了独特的机会，方法：纳入60例具有精确病毒学和组织学评估的抗-HCV阳性肝受体，HCV基因型确定与类型特异性衣壳引物和线探针基因分型试验。结果如下：移植前HCV基因型以Ib型为主（40/60例患者）;肝移植后，这些患者比其他基因型感染的患者更容易发生急性和慢性活动性肝炎（40例患者中的31例和40例患者中的24例vs. 20例患者中的8例和20例患者中的4例），急性肝炎和慢性活动性肝炎的精算率分别为77%和59%，移植后3年感染Ib型和40%（P = 0.008）和22%在其他感染者中，移植前后MCV病毒血症水平与HCV基因型无明显相关性（P = 0.004），而移植后血清HCVRNA水平分别为：在移植后发生肝炎的患者中显著增加。结论：这项研究提供了直接证据，表明HCV Ib与其他基因型相比，更具有侵袭性的复发性肝病相关。
Background/Aims: Several genotypes of hepatitis C virus (HCV) have been identified by phylogenetic analysis, but their clinical relevance remains elusive, Liver transplantation for HCV-related cirrhosis offers a unique opportunity for prospective studies of this issue, Methods: Sixty anti-HCV-positive liver recipients with precise virological, and histological assessments were included, HCV genotype was determined with both type-specific capsid primers and a line probe genotyping assay. Results: HCV genotype Ib was the predominant type before transplantation (40 of 60 patients); after liver transplantation, acute and chronic active hepatitis developed more frequently in these patients than in patients infected by other genotypes (31 of 40 and 24 of 40 vs. 8 of 20 and 4 of 20 patients), Actuarial rates of acute hepatitis and chronic active hepatitis were 77% and 59%, respectively, 3 years after transplantation in patients infected by type Ib and 40% (P = 0.008) and 22% (P = 0.004) in those infected by other types, There was no statistical relation between the level of MCV viremia and HCV genotypes both before and after transplantation, in contrast, after transplantation, serum HCV RNA Values were: significantly increased in patients who developed hepatitis after transplantation. Conclusions: This study provides direct evidence that HCV Ib is associated with more aggressive recurrent liver disease than other genotypes.