The genotype of hepatitis C virus does not affect severity of liver disease after bone marrow transplantation.

Approximately 5% to 15% of patients undergoing bone marrow transplantation (BMT) develop fatal hepatic failure. Recently Frickhofen et al' have suggested that preexisting hepatitis C virus (HCV) infection may predispose to the development of liver failure after BMT whereas other investigators did not find such a correlation?' Because distinct HCV genotypes exist and have been shown to associate with different degrees of liver damage, with HCV Ib causing more severe disease, particularly after liver transplantation, it may be speculated that HCV genotypes could account also for the variable prevalence of liver failure caused by veno-occlusive disease (VOD) in BMT patients infected with HCV. Therefore, we have investigated HCV genotypes in 35 patients with HCV infection who underwent allogeneic BMT in three European centers where posttransplant mortality in HCV-infected patients has been reported as high (Ulm, Germany), intermediate (Genova, Italy), and low (Huddinge, Sweden). In all patients, HCV genotypes, classified according to Simmonds et a1: were identified by hybridization of 5'UTR amplified products with type-specific oligonucleotides probes, as described by Tisminetzky et aL5 The distribution of HCV genotypes in the three BMT units and its relation to different liver disease after BMT are summarized in Table 1. Liver failure was caused by VOD in 7/19 patients (37%), hepatitis (fulminant or subacute) in 8/19 (42%). and hepatic graft-versus-host disease in 4/19 (21%). Thus, in our series there was no clear correlation between the genotype of infecting HCV and the severity of post-BMT liver disease, indicating that the determinants of hepatic complications were independent of the degree of virus cytopathogenicity.