Cytomegalovirus viremia: risk factor for allograft cirrhosis after liver transplantation for hepatitis C.
Transplantation
; 64(5): 721-6, 1997 Sep 15.
Article
em En
| MEDLINE
| ID: mdl-9311709
ABSTRACT
BACKGROUND:
Despite recent advances in diagnosis and treatment, cytomegalovirus (CMV) infection continues to be a common cause of morbidity in liver transplant (LT) recipients. Because CMV infection suppresses cell-mediated immunity, which seems to be important in neutralizing hepatitis C virus (HCV) infection, we assessed the impact of CMV infection on histopathological HCV recurrence after LT.METHODS:
The study group was comprised of 43 consecutive LT recipients with at least 6 months of histologic follow-up. Group 1 consisted of the 8 patients who developed CMV viremia after LT; group 2 comprised the 35 patients without CMV viremia. There was no significant difference with regard to age, initial immunosuppression, incidence of rejection, distribution of HCV genotypes, or mean follow-up between the groups. Semiquantitative histopathologic assessment of allograft hepatitis was performed using the Knodell's score.RESULTS:
The mean total Knodell score of the final allograft biopsy was significantly greater in group 1 patients (P=0.016), with most of the difference due to periportal/bridging necrosis (P=0.009) and lobular activity subitem (P=0.01) scores. Half of the CMV viremic patients eventually developed allograft cirrhosis as compared with 11% of the CMV-negative patients (P=0.027). Accordingly, the cirrhosis-free actuarial survival by Kaplan-Meier estimates was significantly diminished in the CMV viremic patients. Glycoprotein B genotype analysis of CMV isolates revealed no significant differences between patients who did and those who did not develop allograft cirrhosis.CONCLUSIONS:
After LT for chronic HCV, patients who develop CMV viremia incur a significantly greater risk of severe HCV recurrence.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por Citomegalovirus
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Humans
/
Middle aged
Idioma:
En
Revista:
Transplantation
Ano de publicação:
1997
Tipo de documento:
Article
País de afiliação:
Estados Unidos