The meaning of tissue and serum HCV RNA quantitation in hepatitis C recurrence after liver transplantation: A retrospective study

BackgroundWhile the role of serum HCV RNA quantitation in hepatitis C virus recurrence after liver transplantation is well established, the meaning of HCV RNA tissue quantitation is largely unclear, and no correlations with recipient outcome have been investigated yet.AimsTo assess the predictive value, and a possible prognostic role, of tissue and serum HCV RNA in first post-transplant biopsies.MethodsWe retrospectively reviewed the first post-transplant biopsies of 83 recipients. Tissue and serum HCV RNA was quantitated by RT-PCR, and compared with serum, clinical and histological data.ResultsHCV RNA quantitation allowed us to categorise recipients into three different risk groups: (1) tissue HCV RNA ≤ 1.5 IU/ng with any serum HCV RNA; (2) tissue HCV RNA > 1.5 IU/ng and serum HCV RNA < 40 × 106 copies/mL; (3) tissue HCV RNA > 1.5 IU/ng and serum HCV RNA ≥ 40 × 106 copies/mL. Hepatitis C virus recurrence rates in the three groups were 68%, 91% and 100% (P = 0.004); hepatitis C virus-related mortality was 0%, 14% and 45% respectively (P < 0.001).ConclusionsThis preliminary study on serum and tissue HCV RNA quantitation allows recipient “stratification” in prognostic groups, which could be applicable in the future for timely antiviral treatment and/or immunosuppression modulation.