The aim of this study was to evaluate how the immunohistochemical detection of liver hepatitis C virus (HCV) antigens (HCV-Ag) could support the histologic diagnosis and influence the clinical management of post-liver transplantation (LT) liver disease. A total of 215 liver specimens from 152 HCV-positive patients with post-LT liver disease were studied. Histologic coding was: hepatitis (126), rejection (34), undefined (24; coexisting rejection grade I and hepatitis), or other (31). The percentage of HCV-Ag infected hepatocytes were evaluated, on frozen sections, by an immunoperoxidase technique. HCV-Ag were detectable early in 57% of cases within 30 days post-LT, 92% of cases between 31 and 180 days, and 74% of cases after more than 180 days. Overall, HCV-Ag were detected more frequently in histologic hepatitis as compared to rejection (P < 0.0001) with a higher percentage of positive hepatocytes (P < 0.00001). In 16 patients with a high number of HCV-Ag-positive hepatocytes (65%; range 40-90%) a clinical diagnosis of recurrent hepatitis (RHC) was made despite inconclusive histopathologic diagnosis. Multivariate analysis identified the percentage of HCV-Ag-positive hepatocytes and the time post-LT as independent predictors for RHC (P = 0.008 and P = 0.041, respectively) and the number of HCV-Ag-positive hepatocytes >/=50% as the only independent predictor for nonresponse (P < 0.001) in 26 patients treated with alpha-interferon plus ribavirin. In conclusion, HCV reinfection occurs early post-LT, reaching its peak within 6 months. Immunohistochemical detection of post-LT HCV reinfection support the diagnosis of hepatitis when the histologic features are not conclusive. A high number of infected cells, independently from the genotype, represents a negative predictive factor of response to antiviral treatment.

Detection of HCV antigens in liver graft: Relevance to the management of recurrent post-liver transplant hepatitis C / Grassi, Alberto; Quarneti, C; Ravaioli, Matteo; Bianchini, F; Susca, M; D'Errico, Antonietta; Piscaglia, Fabio; Tame', Mariarosa; Andreone, Pietro; Grazi, Gian Luca; Galli, S; Zauli, Daniela; Pinna, Antonio Daniele; Bianchi, Francesco Bianco; Ballardini, G.. - In: LIVER TRANSPLANTATION. - ISSN 1527-6465. - 12:11(2006), pp. 1673-1681. [10.1002/lt.20882]

Detection of HCV antigens in liver graft: Relevance to the management of recurrent post-liver transplant hepatitis C

GRASSI, ALBERTO;ANDREONE, PIETRO;PINNA, ANTONIO DANIELE;
2006

Abstract

The aim of this study was to evaluate how the immunohistochemical detection of liver hepatitis C virus (HCV) antigens (HCV-Ag) could support the histologic diagnosis and influence the clinical management of post-liver transplantation (LT) liver disease. A total of 215 liver specimens from 152 HCV-positive patients with post-LT liver disease were studied. Histologic coding was: hepatitis (126), rejection (34), undefined (24; coexisting rejection grade I and hepatitis), or other (31). The percentage of HCV-Ag infected hepatocytes were evaluated, on frozen sections, by an immunoperoxidase technique. HCV-Ag were detectable early in 57% of cases within 30 days post-LT, 92% of cases between 31 and 180 days, and 74% of cases after more than 180 days. Overall, HCV-Ag were detected more frequently in histologic hepatitis as compared to rejection (P < 0.0001) with a higher percentage of positive hepatocytes (P < 0.00001). In 16 patients with a high number of HCV-Ag-positive hepatocytes (65%; range 40-90%) a clinical diagnosis of recurrent hepatitis (RHC) was made despite inconclusive histopathologic diagnosis. Multivariate analysis identified the percentage of HCV-Ag-positive hepatocytes and the time post-LT as independent predictors for RHC (P = 0.008 and P = 0.041, respectively) and the number of HCV-Ag-positive hepatocytes >/=50% as the only independent predictor for nonresponse (P < 0.001) in 26 patients treated with alpha-interferon plus ribavirin. In conclusion, HCV reinfection occurs early post-LT, reaching its peak within 6 months. Immunohistochemical detection of post-LT HCV reinfection support the diagnosis of hepatitis when the histologic features are not conclusive. A high number of infected cells, independently from the genotype, represents a negative predictive factor of response to antiviral treatment.
2006
12
11
1673
1681
Detection of HCV antigens in liver graft: Relevance to the management of recurrent post-liver transplant hepatitis C / Grassi, Alberto; Quarneti, C; Ravaioli, Matteo; Bianchini, F; Susca, M; D'Errico, Antonietta; Piscaglia, Fabio; Tame', Mariarosa; Andreone, Pietro; Grazi, Gian Luca; Galli, S; Zauli, Daniela; Pinna, Antonio Daniele; Bianchi, Francesco Bianco; Ballardini, G.. - In: LIVER TRANSPLANTATION. - ISSN 1527-6465. - 12:11(2006), pp. 1673-1681. [10.1002/lt.20882]
Grassi, Alberto; Quarneti, C; Ravaioli, Matteo; Bianchini, F; Susca, M; D'Errico, Antonietta; Piscaglia, Fabio; Tame', Mariarosa; Andreone, Pietro; Gr...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1237193
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