Assessment of infection in Iranian cirrhotic patients on the waiting list for liver transplantation: A cross-sectional analysis.

BACKGROUND

() is involved in autoimmunity. However, its association with advanced liver disease has not been fully explained. Herein, the prevalence of viremia was assessed in Iranian liver transplant candidates with a confirmed diagnosis of cirrhosis.

METHODS

This cross-sectional study was conducted on 230 patients with cryptogenic cirrhosis, virus-related cirrhosis, and autoimmune hepatitis, as well as 140 healthy blood donors from April 2022 to September 2023. The IgG antibody concentration and viral load were evaluated ELISA and RT‒PCR, respectively.

RESULTS

Anti- IgG antibodies were detected in 25 cirrhotic patients (10.8 %) and four healthy individuals (2.6 %) (p = 0.022). The majority of the seropositive patients had cryptogenic cirrhosis (20.4 %), followed by autoimmune hepatitis (13.1 %) and virus-related cirrhosis (4.7 %). The seropositivity of IgG antibody was significantly different among the etiologies of liver cirrhosis (p = 0.011). However, genomic DNA was not detected in the sera of the patients or healthy blood donors.

CONCLUSION

The role of infection in the development of posttransplant diseases, together with the higher seroprevalence of antibodies in cirrhotic patients than in healthy individuals, highlights the importance of both primary and latent infections in liver transplantation. Therefore, serological and molecular screening of is highly suggested for liver transplant candidates and organ donors. The possibility of antibody-mediated epitope mimicry in cryptogenic and autoimmune groups with moderate antibody positivity and negative viral loads may account for the development of advanced liver diseases.