Hepatitis C virus in peripheral blood mononuclear cells from a chronically infected patient receiving liver graft from infected donor

Background. In hepatitis C virus (HCV)-positive patients receiving HCV- positive liver allografts either the donor or recipient strain overtakes the other strain. Whether these changes are reflected in peripheral blood mononuclear cell (PBMC)-associated virus is unknown. Methods. We analyzed by single-strand conformation polymorphism and sequencing HCV RNA from serum and PBMCs from a liver transplant recipient whose indigenous strain was replaced by the donor strain. Results. Only the recipient strain was detectable in serum and PBMCs 3 and 5 days after transplantation; at day 7 and 8, a mixture of both was present in the PBMCs, but only recipient strain was detectable in serum. This coincided with the peak presence of donor DNA in recipient PBMCs. From day 14 on, HCV sequences in serum and PBMCs were indistinguishable. Conclusions. Overtake phenomenon in the setting of liver transplantation from infected donors to infected recipients is manifested in PBMCs. Cells released from infected graft carry donor HCV strain.