02418nas a2200253   4500008003900000022001400039245007800053210006900131260001800200300001600218490000700234520171500241100001801956700001101974700001101985700001801996700001702014700001702031700001602048700001402064700001902078700001902097856004802116       1999                          d  a1527-335000aRecurrent and new hepatitis C virus infection after liver transplantation0 aRecurrent and new hepatitis C virus infection after liver transp  bW.B. Saunders  a1220 - 12260 v293 aAbstract 10.1002/hep.510290412.abs Chronic infection with the hepatitis C virus (HCV) is the most common reason for liver transplantation. We examined the results of laboratory tests for HCV on a cohort of patients who received a liver transplant between 1990 and 1994 at three large centers. Seven hundred twenty-two recipients and 604 donors were tested for antibody to HCV (anti-HCV) using a second-generation enzyme-linked immunoassay (EIA-2), followed by recombinant immunoblot (RIBA-2) and HCV RNA confirmation by reverse-transcription polymerase chain reaction (RT-PCR) (with genotyping and viral quantification). Diagnosis of posttransplantation infection required detection of serum HCV RNA that could be genotyped by sequencing or was repeatedly positive despite being unsequenceable. Twenty-five percent of transplantation candidates were seropositive for anti-HCV. Approximately 86% of anti-HCV–positive, 93% of RIBA-positive, and 97% of HCV RNA–positive candidates developed infection after transplantation. Pretransplantation HCV RNA was superior to RIBA-2 for predicting posttransplantation infection. Whereas HCV genotype was identified in nearly all candidates and changed little after transplantation, serum viral levels rose markedly after transplantation. Fifteen donors were either anti-HCV– or HCV RNA–positive. Recipients of grafts from donors with HCV RNA all developed infection, whereas infection was not detected in recipients of grafts from donors with anti-HCV but without detectable HCV RNA. The rate of new infection fell significantly (P = .02) after the introduction of EIA-2 screening of blood. Donor and candidate markers for HCV predict posttransplantation infection1 aEverhart, J E1 aWei, Y1 aEng, H1 aCharlton, M R1 aPersing, D H1 aWiesner, R H1 aGermer, J J1 aLake, J R1 aZetterman, R K1 aHoofnagle, J H  uhttps://www.notifylibrary.org/reference/492