Quantification of C4d deposition and hepatitis C virus RNA in tissue in cases of graft rejection and hepatitis C recurrence after liver transplantation

• Published in: Memórias do Instituto Oswaldo Cruz Vol. 110; no. 1; pp. 56 - 64
• Main Authors: Song, Alice Tung Wan, Mello, Evandro Sobroza de, Alves, Venâncio Avancini Ferreira, Cavalheiro, Norma de Paula, Melo, Carlos Eduardo, Bonazzi, Patricia Rodrigues, Tengan, Fatima Mitiko, Freire, Maristela Pinheiro, Barone, Antonio Alci, D'Albuquerque, Luiz Augusto Carneiro, Abdala, Edson
• Format: Journal Article
• Language: English
• Published: Brazil Instituto Oswaldo Cruz, Ministério da Saúde 01.02.2015; Fundação Oswaldo Cruz (FIOCRUZ)
• Subjects: Adolescent; Adult; Aged; Biopsy; complement; Complement C4b - analysis; Diagnosis, Differential; Female; Graft Rejection - immunology; Graft Rejection - pathology; Graft Rejection - virology; Hepacivirus - genetics; Hepacivirus - isolation & purification; Hepatitis C - immunology; Hepatitis C - pathology; Hepatitis C - virology; Humans; humoral; Immunohistochemistry; Liver Transplantation; Male; Middle Aged; PARASITOLOGY; PCR; Peptide Fragments - analysis; Predictive Value of Tests; Recurrence; Retrospective Studies; RNA, Viral - isolation & purification; Severity of Illness Index; tissue; TROPICAL MEDICINE; Young Adult; tissue; immunohistochemistry; complement; humoral; PCR
• ISSN: 0074-0276; 1678-8060; 1678-8060; 0074-0276
• DOI: 10.1590/0074-02760140192

Histology is the gold standard for diagnosing acute rejection and hepatitis C recurrence after liver transplantation. However, differential diagnosis between the two can be difficult. We evaluated the role of C4d staining and quantification of hepatitis C virus (HCV) RNA levels in liver tissue. This was a retrospective study of 98 liver biopsy samples divided into four groups by histological diagnosis: acute rejection in patients undergoing liver transplant for hepatitis C (RejHCV+), HCV recurrence in patients undergoing liver transplant for hepatitis C (HCVTx+), acute rejection in patients undergoing liver transplant for reasons other than hepatitis C and chronic hepatitis C not transplanted (HCVTx-). All samples were submitted for immunohistochemical staining for C4d and HCV RNA quantification. Immunoexpression of C4d was observed in the portal vessels and was highest in the HCVTx- group. There was no difference in C4d expression between the RejHCV+ and HCVTx+ groups. However, tissue HCV RNA levels were higher in the HCVTx+ group samples than in the RejHCV+ group samples. Additionally, there was a significant correlation between tissue and serum levels of HCV RNA. The quantification of HCV RNA in liver tissue might prove to be an efficient diagnostic test for the recurrence of HCV infection.