Hepatitis C virus genotypes and the influence of the induction of immunosuppression with anti-thymocyte globulin (ATG) on chronic hepatitis in renal graft recipients

• Type: Article in International Scientific Journal
• Date: 1998

Authors

Anabela Rodrigues (Author) ICBAS; Pinho, L (Author) Other; lobato, l (Author) ICBAS; Queiros, A (Author) Other; Castro, R (Author) Other; Daniel, M (Author) Other; Dias, L (Author) Other; Castro Henriques, A (Author) Other; Sarmento A (Author) FMUP; Guimaraes, S (Author) Other

Journal

Title: Transplant International

Vol. 11

Pages: S115-S118

ISSN: 0934-0874

Publisher: Wiley-Blackwell

Indexing

Scopus - 6 Citations

Other information

Authenticus ID: P-007-7TF

Abstract (EN): Hepatitis C virus (HCV) exhibits a dramatic genetic variability and several mechanisms of immunological response are unable to control hepatic and extrahepatic replication. Genotype 1b is associated with more severe clinical manifestations and is less responsive to interferon. In addition, we have reported an increase of HCV RNA viral load after renal transplantation. Anti-thymocyte globulin (ATG) is supposed to increase viral replication and liver dysfunction in chronically infected renal graft recipients. We evaluated the genotype profile in HCV + patients of our Renal Transplant Unit and studied the effects of ATG, as part of the induction of immunosuppression, on viral load and liver enzymes abnormalities. From 726 renal graft recipients, 104 patients, with a mean follow up of 3.9 ± 2.9 years, were anti-HCV + by ELISA II. HCV RNA was measured by quantitative PCR. We correlated the viral load and biochemical liver parameters with genotype, exposure to ATG as induction therapy, early acute rejection episode and the duration of infection. Of the 81 patients tested, 72% were viraemic and genotype 1b was the predominant viral strain (66%). The majority of these patients (65%) were coinfected by two or more strains.There was no correlation between HCV RNA blood levels and liver enzymes. We did not find higher viral load with genotype 1 b infection (68 ± 88 mEq/ml vs 75.8 ± 123 mEq/ml in the others) nor with ATG induction therapy (43.5 ± 71.3 mEq/ml vs 64.1 ± 110.5 mEq/ml). Early acute rejection and longer follow up were not associated with higher levels of HCV RNA. The biochemical liver profile showed no relationship with the variables studied. We concluded that genotype 1b is the predominant strain in our HCV + population and there is a great prevalence of coinfection with several genotypes. Our results did not confirm a deleterious effect of the use of ATG as induction therapy in these HCV-infected patients. Prospective randomised studies with liver biopsy evaluation are needed to answer more fully the remaining questions about the best immunosuppressive therapy in renal graft recipients with chronic HCV infection. © Springer-Verlag 1998.

Language: English

Type (Professor's evaluation): Scientific