Background: Virological recurrence after liver transplantation in cirrhotic patients due to chronic HCV is universal, however not all patients develop clinical recurrence detected by elevated transaminases, positive HCV RNA by PCR and histopathological inflammatory activity. Interleukin 28B (rs12979860) (IL-28B) gene polymorphisms (CC) is known to be associated with better response of chronic HCV to treatment and less complications.
Aim: The aim of this study is to evaluate the relationship between the recipient IL-28B (rs 12979860) and clinical recurrence of HCV after living donor transplantation.
Patients and methods: Fifty patients who underwent living donor liver transplantation due to HCV liver cirrhosis with or without HCC were tested for IL-28B (rs 12979860)) polymorphisms. Demographic, laboratory and histopathological data of patients were collected. Follow up until 6 months after liver transplantation was done. Clinical recurrence of HCV was considered if there is unexplained elevated liver enzymes associated with positive HCV RNA by PCR and confirmed by inflammatory activity in liver biopsy. Predictors of clinical recurrence were identified by univariate and multivariate analysis.
Results: Out of the 50 patients 10 (20%) had CC allele, 9 (18%) had TT allele and 31 (62%) had CT allele of IL-28B polymorphisms. Clinical recurrence was associated with older donor age (p value= 0.04), low platelet count (p =0.02), high pre and post-transplant viral load (p=0.001), low post-transplant hemoglobin (p=0.05), high ALT (p=0.001), high AST (p=0.001) and presence of T allele IL-28B (p=0.04). Clinical recurrence was found in 2/10 patients with CC (20%), 8/21 with CT (38.1%) and in 6/9 with TT (66.6%). The only independent predictor for clinical HCV recurrence in logistic regression analysis was post-transplant HCV RNA viral load.
Conclusions: A substantial number of living donor liver transplantation due to HCV has clinical recurrence and this was significantly higher in patients who have T allele of IL-28B polymorphism. The independent predictors for clinical recurrence is the high viral load,
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