Outcome of de novo hepatitis C virus infection in heart transplant recipients

Janus P. Ong, David S. Barnes*, Zobair M. Younossi, Terry Gramlich, Belinda Yen-Lieberman, Marlene Goormastic, Cedric Sheffield, Kathy Hoercher, Randall Starling, James Young, Nicholas Smedira, Patrick Mccarthy

*Corresponding author for this work

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67 Scopus citations

Abstract

The outcome of de novo hepatitis C virus (HCV) infection in heart transplant recipients of HCV-antibody positive organs is not known. The aim of the study was to determine the short-term outcome of de novo HCV infection in recipients of HCV-positive donor organs. HCV-antibody negative recipients of HCV-antibody positive hearts were identified from January 1, 1991 to February 28, 1998. Control patients matched for year of transplantation were also identified. Twenty-eight patients (22 males, mean age of 56 ± 11 SD) received hearts from HCV-antibody-positive donors. The control group was similar to the patients in all clinical and demographic aspects. Twenty-three patients had detectable viremia by reverse-transcription polymerase chain reaction (RT-PCR). Of these 23 patients with de novo HCV infection, 7 (30%) developed HCV-related liver disease. Three patients (13%) had chronic hepatitis and 4 patients (17%) developed severe acute cholestatic hepatitis (ACH). Mycophenolate mofetil (MMF) use (P = .04) and high viral load at onset of acute liver disease (P = .02) were associated with ACH. Overall survival was similar between patients with de novo HCV infection and controls (P = .20). Development of ACH (P = .02) and MMF use (P = .0009) were associated with decreased survival in patients with de novo HCV infection. The present study showed that survival of patients with de novo HCV infection was similar to a matched control group. HCV-related severe ACH is associated with a poor short-term outcome in patients with de novo HCV infection. MMF use may be associated with a higher incidence of HCV-related severe ACH and a poor short-term outcome.

Original languageEnglish (US)
Pages (from-to)1293-1298
Number of pages6
JournalHepatology
Volume30
Issue number5
DOIs
StatePublished - 1999

ASJC Scopus subject areas

  • Hepatology

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    Ong, J. P., Barnes, D. S., Younossi, Z. M., Gramlich, T., Yen-Lieberman, B., Goormastic, M., Sheffield, C., Hoercher, K., Starling, R., Young, J., Smedira, N., & Mccarthy, P. (1999). Outcome of de novo hepatitis C virus infection in heart transplant recipients. Hepatology, 30(5), 1293-1298. https://doi.org/10.1002/hep.510300519