Hepatitis C virus genotypes in liver transplant recipients

Impact on posttransplant recurrence, infections, response to interferon-α therapy and outcome

Timothy Gayowski, Nina Singh, Ignazio R. Marino, Hugo E Vargas, Marilyn Wagener, Cheryl Wannstedt, Franca Morelli, Tomasz Laskus, John J. Fung, Jorge Rakela, Thomas E. Starzl

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Background. End-stage liver disease due to hepatitis C virus (HCV) is the most common indication for liver transplantation in U.S. veterans. We investigated the influence of HCV genotypes on the incidence and timing of recurrent HCV hepatitis, survival, infectious morbidity, and response to interferon-α therapy in this unique patient population. Methods. HCV genotype was determined by direct sequencing of the NS5 region of HCV with type-specific primers. Results. Genotype 1a (66%, 32/47) was the predominant genotype. Type 1b was found in 25% (12/47) of patients and type 2b was found in 9% (4/47). His topathologically recurrent HCV hepatitis developed in 53% (25/47) of the patients after transplantation. This group included 45% (14/31) of the patients with type 1a, 67% (8/12) of the patients with type 1b, and 25% (1/4) of the patients with type 2b (P>0.5). The time to recurrence and the severity of HCV recurrence as defined by aminotransferase levels or Knodell scores were not different among the three genotypes. There was a trend toward a higher incidence of major infections in patients with type 1b (75%) versus type 1a (48%) and type 2b (50%) (P=0.11). The response to interferon-α therapy did not differ significantly among the genotypes. Mortality at 5 years was 16% (5/31) in patients with genotype 1a, 42% (5/12) in patients with genotype 1b, and 50% (2/4) in patients with genotype 2b (P=0.06). Conclusions. The incidence, time to recurrence, and response to interferon-α therapy did not differ be tween the various genotypes in our liver transplant recipients. However, there was a trend toward higher infectious morbidity and overall mortality in patients with genotype 1b after transplantation.

Original languageEnglish (US)
Pages (from-to)422-426
Number of pages5
JournalTransplantation
Volume64
Issue number3
DOIs
StatePublished - Aug 15 1997
Externally publishedYes

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Hepacivirus
Interferons
Genotype
Recurrence
Liver
Infection
Therapeutics
Incidence
Transplant Recipients
Transplantation
Morbidity
End Stage Liver Disease
Hepatitis A
Mortality
Polysorbates
Veterans
Transaminases
Liver Transplantation
Hepatitis
Survival

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Hepatitis C virus genotypes in liver transplant recipients : Impact on posttransplant recurrence, infections, response to interferon-α therapy and outcome. / Gayowski, Timothy; Singh, Nina; Marino, Ignazio R.; Vargas, Hugo E; Wagener, Marilyn; Wannstedt, Cheryl; Morelli, Franca; Laskus, Tomasz; Fung, John J.; Rakela, Jorge; Starzl, Thomas E.

In: Transplantation, Vol. 64, No. 3, 15.08.1997, p. 422-426.

Research output: Contribution to journalArticle

Gayowski, Timothy ; Singh, Nina ; Marino, Ignazio R. ; Vargas, Hugo E ; Wagener, Marilyn ; Wannstedt, Cheryl ; Morelli, Franca ; Laskus, Tomasz ; Fung, John J. ; Rakela, Jorge ; Starzl, Thomas E. / Hepatitis C virus genotypes in liver transplant recipients : Impact on posttransplant recurrence, infections, response to interferon-α therapy and outcome. In: Transplantation. 1997 ; Vol. 64, No. 3. pp. 422-426.
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abstract = "Background. End-stage liver disease due to hepatitis C virus (HCV) is the most common indication for liver transplantation in U.S. veterans. We investigated the influence of HCV genotypes on the incidence and timing of recurrent HCV hepatitis, survival, infectious morbidity, and response to interferon-α therapy in this unique patient population. Methods. HCV genotype was determined by direct sequencing of the NS5 region of HCV with type-specific primers. Results. Genotype 1a (66{\%}, 32/47) was the predominant genotype. Type 1b was found in 25{\%} (12/47) of patients and type 2b was found in 9{\%} (4/47). His topathologically recurrent HCV hepatitis developed in 53{\%} (25/47) of the patients after transplantation. This group included 45{\%} (14/31) of the patients with type 1a, 67{\%} (8/12) of the patients with type 1b, and 25{\%} (1/4) of the patients with type 2b (P>0.5). The time to recurrence and the severity of HCV recurrence as defined by aminotransferase levels or Knodell scores were not different among the three genotypes. There was a trend toward a higher incidence of major infections in patients with type 1b (75{\%}) versus type 1a (48{\%}) and type 2b (50{\%}) (P=0.11). The response to interferon-α therapy did not differ significantly among the genotypes. Mortality at 5 years was 16{\%} (5/31) in patients with genotype 1a, 42{\%} (5/12) in patients with genotype 1b, and 50{\%} (2/4) in patients with genotype 2b (P=0.06). Conclusions. The incidence, time to recurrence, and response to interferon-α therapy did not differ be tween the various genotypes in our liver transplant recipients. However, there was a trend toward higher infectious morbidity and overall mortality in patients with genotype 1b after transplantation.",
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T1 - Hepatitis C virus genotypes in liver transplant recipients

T2 - Impact on posttransplant recurrence, infections, response to interferon-α therapy and outcome

AU - Gayowski, Timothy

AU - Singh, Nina

AU - Marino, Ignazio R.

AU - Vargas, Hugo E

AU - Wagener, Marilyn

AU - Wannstedt, Cheryl

AU - Morelli, Franca

AU - Laskus, Tomasz

AU - Fung, John J.

AU - Rakela, Jorge

AU - Starzl, Thomas E.

PY - 1997/8/15

Y1 - 1997/8/15

N2 - Background. End-stage liver disease due to hepatitis C virus (HCV) is the most common indication for liver transplantation in U.S. veterans. We investigated the influence of HCV genotypes on the incidence and timing of recurrent HCV hepatitis, survival, infectious morbidity, and response to interferon-α therapy in this unique patient population. Methods. HCV genotype was determined by direct sequencing of the NS5 region of HCV with type-specific primers. Results. Genotype 1a (66%, 32/47) was the predominant genotype. Type 1b was found in 25% (12/47) of patients and type 2b was found in 9% (4/47). His topathologically recurrent HCV hepatitis developed in 53% (25/47) of the patients after transplantation. This group included 45% (14/31) of the patients with type 1a, 67% (8/12) of the patients with type 1b, and 25% (1/4) of the patients with type 2b (P>0.5). The time to recurrence and the severity of HCV recurrence as defined by aminotransferase levels or Knodell scores were not different among the three genotypes. There was a trend toward a higher incidence of major infections in patients with type 1b (75%) versus type 1a (48%) and type 2b (50%) (P=0.11). The response to interferon-α therapy did not differ significantly among the genotypes. Mortality at 5 years was 16% (5/31) in patients with genotype 1a, 42% (5/12) in patients with genotype 1b, and 50% (2/4) in patients with genotype 2b (P=0.06). Conclusions. The incidence, time to recurrence, and response to interferon-α therapy did not differ be tween the various genotypes in our liver transplant recipients. However, there was a trend toward higher infectious morbidity and overall mortality in patients with genotype 1b after transplantation.

AB - Background. End-stage liver disease due to hepatitis C virus (HCV) is the most common indication for liver transplantation in U.S. veterans. We investigated the influence of HCV genotypes on the incidence and timing of recurrent HCV hepatitis, survival, infectious morbidity, and response to interferon-α therapy in this unique patient population. Methods. HCV genotype was determined by direct sequencing of the NS5 region of HCV with type-specific primers. Results. Genotype 1a (66%, 32/47) was the predominant genotype. Type 1b was found in 25% (12/47) of patients and type 2b was found in 9% (4/47). His topathologically recurrent HCV hepatitis developed in 53% (25/47) of the patients after transplantation. This group included 45% (14/31) of the patients with type 1a, 67% (8/12) of the patients with type 1b, and 25% (1/4) of the patients with type 2b (P>0.5). The time to recurrence and the severity of HCV recurrence as defined by aminotransferase levels or Knodell scores were not different among the three genotypes. There was a trend toward a higher incidence of major infections in patients with type 1b (75%) versus type 1a (48%) and type 2b (50%) (P=0.11). The response to interferon-α therapy did not differ significantly among the genotypes. Mortality at 5 years was 16% (5/31) in patients with genotype 1a, 42% (5/12) in patients with genotype 1b, and 50% (2/4) in patients with genotype 2b (P=0.06). Conclusions. The incidence, time to recurrence, and response to interferon-α therapy did not differ be tween the various genotypes in our liver transplant recipients. However, there was a trend toward higher infectious morbidity and overall mortality in patients with genotype 1b after transplantation.

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