Association of cytomegalovirus infection and disease with recurrent hepatitis C after liver transplantation

Wendelyn Bosch, Michael G. Heckman, Surakit Pungpapong, Nancy N. Diehl, Jefree A. Shalev, Walter C. Hellinger

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background. Cytomegalovirus (CMV) has been inconsistently associated with recurrent hepatitis C virus (HCV) after liver transplant (LT). Methods. A retrospective study of 347, donor or recipient CMV seropositive, first LT recipients transplanted for HCV was performed to evaluate the associations of CMV infection and disease occurring within 1-year of LT with the primary endpoints of allograft inflammation grade ≥2 and fibrosis stage ≥2. Associations were evaluated using multivariable Cox regression models. Results. CMV infection and disease occurred in 111 (32%) and 24 (7%) patients, respectively. Hepatic allograft inflammation grade ≥2 and fibrosis stage ≥2 occurred in 221 (64%) and 140 (40%) patients, respectively. CMV infection was associated with increased risk of fibrosis stage ≥2 (relative risk [RR], 1.52; P=0.033). CMV disease was associated with increased risk of inflammation grade ≥2 (RR, 3.40; P<0.001), and although not significant, with fibrosis stage ≥2 (RR, 2.03; P=0.052). These associations did not differ significantly according to recipient CMV seropositivity. Conclusions. Our results support an association between CMV infection and disease with recurrence of HCV after LT. Investigation of prevention of CMV infection and disease as a strategy to mitigate recurrent HCV in LT recipients is warranted.

Original languageEnglish (US)
Pages (from-to)723-728
Number of pages6
JournalTransplantation
Volume93
Issue number7
DOIs
StatePublished - Apr 15 2012

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Cytomegalovirus Infections
Hepatitis C
Liver Transplantation
Cytomegalovirus
Hepacivirus
Liver
Fibrosis
Inflammation
Transplants
Allografts
Proportional Hazards Models
Retrospective Studies
Tissue Donors
Recurrence

Keywords

  • Cytomegalovirus
  • Death
  • Graft loss
  • Hepatitis C virus
  • Liver transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Association of cytomegalovirus infection and disease with recurrent hepatitis C after liver transplantation. / Bosch, Wendelyn; Heckman, Michael G.; Pungpapong, Surakit; Diehl, Nancy N.; Shalev, Jefree A.; Hellinger, Walter C.

In: Transplantation, Vol. 93, No. 7, 15.04.2012, p. 723-728.

Research output: Contribution to journalArticle

Bosch, Wendelyn ; Heckman, Michael G. ; Pungpapong, Surakit ; Diehl, Nancy N. ; Shalev, Jefree A. ; Hellinger, Walter C. / Association of cytomegalovirus infection and disease with recurrent hepatitis C after liver transplantation. In: Transplantation. 2012 ; Vol. 93, No. 7. pp. 723-728.
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abstract = "Background. Cytomegalovirus (CMV) has been inconsistently associated with recurrent hepatitis C virus (HCV) after liver transplant (LT). Methods. A retrospective study of 347, donor or recipient CMV seropositive, first LT recipients transplanted for HCV was performed to evaluate the associations of CMV infection and disease occurring within 1-year of LT with the primary endpoints of allograft inflammation grade ≥2 and fibrosis stage ≥2. Associations were evaluated using multivariable Cox regression models. Results. CMV infection and disease occurred in 111 (32{\%}) and 24 (7{\%}) patients, respectively. Hepatic allograft inflammation grade ≥2 and fibrosis stage ≥2 occurred in 221 (64{\%}) and 140 (40{\%}) patients, respectively. CMV infection was associated with increased risk of fibrosis stage ≥2 (relative risk [RR], 1.52; P=0.033). CMV disease was associated with increased risk of inflammation grade ≥2 (RR, 3.40; P<0.001), and although not significant, with fibrosis stage ≥2 (RR, 2.03; P=0.052). These associations did not differ significantly according to recipient CMV seropositivity. Conclusions. Our results support an association between CMV infection and disease with recurrence of HCV after LT. Investigation of prevention of CMV infection and disease as a strategy to mitigate recurrent HCV in LT recipients is warranted.",
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