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Immunosuppressive therapy and hepatitis C virus infection: the
clinical course of liver disease
In a retrospective long-term follow-up study the clinical course
of liver disease was examined in renal allograft recipients with
hepatitis C virus (HCV) infection and negative hepatitis B surface
antigen under immunosuppressive therapy. We compared 42 anti-HCV
antibody (anti-HCV) positive patients (study group) to 213 anti-HCV
negative patients (control group). All patients received
immunosuppressive therapy. Measurements were made of the following:
aminotransferases, bilirubin, albumin, gammaglobulins, ascites,
spleen diameter, HCV RNA, and anti-HCV antibody. We found all but
four anti-HCV positive patients to be HCV RNA positive prior to
transplantation. There were no differences in overall mortality or
mortality secondary to liver disease or sepsis. Normal liver
enzymes were found in 13 (31%) anti-HCV positive and in 137 (64%)
anti-HCV negative patients during the whole mean observation period
of 65 months (range 10-215). Aminotransferase activity decreased in
anti-HCV positive and negative patients during the observation
period. Liver function with regard to synthesis and excretion was
normal in anti-HCV negative and anti-HCV positive patients. No
signs of portal hypertension were observed in the anti-HCV positive
group. Neither the different immunosuppressive regimens nor the
antirejection therapy led to differences between anti-HCV positive
and negative groups with respect to liver function and did not
alter the clinical course. We conclude that HCV infection in
patients under immunosuppressive therapy causes only a mild liver
disease, as determined by clinicochemical and clinical parameters,
and that mortality rate is not increased.
Author: Grotz WH, Peters TH, Schlayer HJ, Kirste G, Berthold
H, Felten H, Schollmeyer PJ, Rasenack JW, Department of Internal
Medicine, Universitatsklinik Freiburg, Germany.
Source: J Mol Med 74: 407-412 (1996)
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