巨细胞病毒感染和疾病与肝移植后丙型肝炎复发的关系。

Association of cytomegalovirus infection and disease with recurrent hepatitis C after liver transplantation.

机构信息

Division of Infectious Diseases, Mayo Clinic in Florida, Jacksonville, FL, USA.

出版信息

Transplantation. 2012 Apr 15;93(7):723-8. doi: 10.1097/TP.0b013e3182472876.

DOI:10.1097/TP.0b013e3182472876

PMID:22406819

Abstract

BACKGROUND

Cytomegalovirus (CMV) has been inconsistently associated with recurrent hepatitis C virus (HCV) after liver transplant (LT).

METHODS

A retrospective study of 347, donor or recipient CMV seropositive, first LT recipients transplanted for HCV was performed to evaluate the associations of CMV infection and disease occurring within 1-year of LT with the primary endpoints of allograft inflammation grade ≥2 and fibrosis stage ≥2. Associations were evaluated using multivariable Cox regression models.

RESULTS

CMV infection and disease occurred in 111 (32%) and 24 (7%) patients, respectively. Hepatic allograft inflammation grade ≥2 and fibrosis stage ≥2 occurred in 221 (64%) and 140 (40%) patients, respectively. CMV infection was associated with increased risk of fibrosis stage ≥2 (relative risk [RR], 1.52; P=0.033). CMV disease was associated with increased risk of inflammation grade ≥2 (RR, 3.40; P<0.001), and although not significant, with fibrosis stage ≥2 (RR, 2.03; P=0.052). These associations did not differ significantly according to recipient CMV seropositivity.

CONCLUSIONS

Our results support an association between CMV infection and disease with recurrence of HCV after LT. Investigation of prevention of CMV infection and disease as a strategy to mitigate recurrent HCV in LT recipients is warranted.

摘要

背景

巨细胞病毒（CMV）与肝移植（LT）后丙型肝炎病毒（HCV）的复发性之间的关系一直不一致。

方法

对 347 名 HCV 移植受者进行了一项回顾性研究，这些受者均为供体或受者 CMV 血清阳性，目的是评估 LT 后 1 年内 CMV 感染和疾病与移植物炎症程度≥2 级和纤维化分期≥2 级的主要终点之间的关系。采用多变量 Cox 回归模型评估相关性。

结果

111 例（32%）和 24 例（7%）患者分别发生 CMV 感染和疾病。221 例（64%）和 140 例（40%）患者分别发生肝移植炎症程度≥2 级和纤维化分期≥2 级。CMV 感染与纤维化分期≥2 级的风险增加相关（相对风险 [RR]，1.52；P=0.033）。CMV 疾病与炎症程度≥2 级的风险增加相关（RR，3.40；P<0.001），尽管无统计学意义，但与纤维化分期≥2 级的风险增加相关（RR，2.03；P=0.052）。这些相关性在受者 CMV 血清阳性的情况下无显著差异。