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≤1.5IU/ng with any serum HCV RNA; (2) tissue HCV RNA>1.5IU/ng and serum HCV RNA<40×10(6)copies/mL; (3) tissue HCV RNA>1.5IU/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.