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

Background: While 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.

Aims: To assess the predictive value, and a possible prognostic role, of tissue and serum HCV RNA in first post-transplant biopsies.

Methods: We 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.

Results: HCV 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 × 10(6)copies/mL; (3) tissue HCV RNA>1.5 IU/ng and serum HCV RNA ≥ 40 × 10(6)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).

Conclusions: This 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.