>From the Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Exp Clin Transplant. 2020 Apr;18(2):206-209. doi: 10.6002/ect.2017.0332. Epub 2018 Oct 19.
Investigations into the viral causes of end-stage liver disease in liver transplant patients with cryptogenic underlying disease remain of interest. Hepatitis C virus infection, especially in its silent (occult) form, may play a key role in the introduction and development of cryptogenic cirrhosis. We aimed to determine the prevalence of occult hepatitis C virus infection in liver transplant recipients with cryptogenic cirrhosis.
In this cross-sectional study, 127 liver transplant recipients confirmed to have cryptogenic cirrhosis were included. Plasma samples of the patients underwent evaluation for hepatitis C virus antibody using the enzyme-linked immunosorbent assay method. Plasma samples and paraffin-embedded liver tissue samples were tested for hepatitis C virus RNA using nested reverse transcriptase-polymerase chain reaction.
Hepatitis C virus RNA was detected in liver tissue sections of 10 patients (7.9%). However, none of the cryptogenic patients had hepatitis C virus RNA or antibody in their plasma samples. None of the patients had hepatitis C or G virus coinfection, but simultaneous detection of hepatitis B and hepatitis C virus was diagnosed in 4 liver tissue samples.
A finding of hepatitis C virus RNA in liver tissue samples of transplant recipients presents the historical possibility of occult hepatitis C virus infection as underlying disease in our patients with cryptogenic cirrhosis. Results present an important and determinative role of occult hepatitis C virus infection in the pathogenesis of cryptogenic cirrhosis, which needs further confirmation in additional studies.
对于患有隐匿性基础疾病的肝移植患者终末期肝病的病毒病因研究仍然具有重要意义。丙型肝炎病毒感染，尤其是隐匿性（隐性）形式，可能在隐匿性肝硬化的发生和发展中起关键作用。我们旨在确定隐匿性丙型肝炎病毒感染在隐匿性肝硬化肝移植受者中的流行率。
在这项横断面研究中，纳入了 127 例经证实患有隐匿性肝硬化的肝移植受者。使用酶联免疫吸附测定法检测患者的血浆样本中丙型肝炎病毒抗体。使用巢式逆转录聚合酶链反应检测血浆样本和石蜡包埋的肝组织样本中的丙型肝炎病毒 RNA。
在 10 例患者（7.9%）的肝组织切片中检测到丙型肝炎病毒 RNA。然而，在隐匿性患者的血浆样本中均未检测到丙型肝炎病毒 RNA 或抗体。患者均无丙型肝炎或戊型肝炎病毒合并感染，但在 4 例肝组织样本中同时诊断出乙型肝炎和丙型肝炎病毒感染。
在肝移植受者的肝组织样本中检测到丙型肝炎病毒 RNA，提示我们的隐匿性肝硬化患者存在隐匿性丙型肝炎病毒感染的既往可能性。结果提示隐匿性丙型肝炎病毒感染在隐匿性肝硬化发病机制中具有重要且决定性作用，这需要在进一步的研究中得到进一步证实。
