| Autor: |
GRASSI, ALBERTO, RAVAIOLI, MATTEO, D'ERRICO, ANTONIETTA, PISCAGLIA, FABIO, TAME', MARIAROSA, ANDREONE, PIETRO, GRAZI, GIAN LUCA, ZAULI, DANIELA, PINNA, ANTONIO DANIELE, BIANCHI, FRANCESCO BIANCO, Quarneti C, Bianchini F, Susca M, Galli S, Ballardini G. |
| Přispěvatelé: |
Grassi A, Quarneti C, Ravaioli M, Bianchini F, Susca M, D'Errico A, Piscaglia F, Tame MR, Andreone P, Grazi G, Galli S, Zauli D, Pinna AD, Bianchi FB, Ballardini G. |
| Jazyk: |
angličtina |
| Rok vydání: |
2006 |
| Předmět: |
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| Popis: |
The aim of this study was to evaluate how the immunohistochemical detection of liver hepatitis C virus (HCV) antigens (HCV-Ag) could support the histologic diagnosis and influence the clinical management of post-liver transplantation (LT) liver disease. A total of 215 liver specimens from 152 HCV-positive patients with post-LT liver disease were studied. Histologic coding was: hepatitis (126), rejection (34), undefined (24; coexisting rejection grade I and hepatitis), or other (31). The percentage of HCV-Ag infected hepatocytes were evaluated, on frozen sections, by an immunoperoxidase technique. HCV-Ag were detectable early in 57% of cases within 30 days post-LT, 92% of cases between 31 and 180 days, and 74% of cases after more than 180 days. Overall, HCV-Ag were detected more frequently in histologic hepatitis as compared to rejection (P < 0.0001) with a higher percentage of positive hepatocytes (P < 0.00001). In 16 patients with a high number of HCV-Ag-positive hepatocytes (65%; range 40-90%) a clinical diagnosis of recurrent hepatitis (RHC) was made despite inconclusive histopathologic diagnosis. Multivariate analysis identified the percentage of HCV-Ag-positive hepatocytes and the time post-LT as independent predictors for RHC (P = 0.008 and P = 0.041, respectively) and the number of HCV-Ag-positive hepatocytes >/=50% as the only independent predictor for nonresponse (P < 0.001) in 26 patients treated with alpha-interferon plus ribavirin. In conclusion, HCV reinfection occurs early post-LT, reaching its peak within 6 months. Immunohistochemical detection of post-LT HCV reinfection support the diagnosis of hepatitis when the histologic features are not conclusive. A high number of infected cells, independently from the genotype, represents a negative predictive factor of response to antiviral treatment. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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