The predictors of post-transplantation hepatitis C virus (HCV)-related liver disease remain unclear.
In addition, the impact of HCV genotype on the outcome of transplantation has not been established.
In this study, a team of physicians from Birmingham, England, examined the outcome of liver transplantation in patients with infected with HCV genotype 4.
The team assessed 128 patients who underwent transplantation for HCV infection. Of these, 28 patients were infected with genotype 1, 11 with genotype 2, 19 with genotype 3, and 32 with genotype 4.
The team determined that the median interval from transplantation to biopsy was 1.92 years.
|5-year survival rates were similar for the different genotypes.|
They found that 26% of HCV genotype 4 patients developed either severe fibrosis or cirrhosis, compared with 7% of patients with other genotypes.
Furthermore, a greater fibrosis progression rate was observed in patients with genotype 4.
Univariate and multivariate analysis found that rapid liver fibrosis was associated with the presence of HCV genotype 4 infection.
Donor and recipient age, and graft warm ischemic time also were associated with the rate of fibrosis progression.
The investigators established that the 5-year cumulative rate for the development of cirrhosis or severe fibrosis was 84% in genotype 4 patients, and 24% in other genotypes.
In addition, the 5-year survival rates for patients with genotypes 1, 2 and 3, and 4 were 72%, 80%, and 79%, respectively.
Dr Mohamed Wali's team concluded, "5-year survival for patients who underwent transplantation for HCV genotype-4 infection was similar to that of genotype non-4 patients".
"However, more severe fibrosis and rapid fibrosis progression was observed after transplantation in patients with genotype-4 infection".