291 Monitoring Peripheral Blood CD4+ Adenosine Triphosphate (ATP) Activity in Orthotopic Liver Transplantation (OLT) Recipients with Hepatitis C Virus (HCV) Infection and Its Correlation to Fibrosis Progression

Abstract

liver disease from other etiologies (hepatitis B or C, alcohol abuse or iron overload). Toxicants were included in the analysis if 60% or more of subjects had detectable levels. We ended up with 116 toxicants in the analysis. Subjects were stratified by toxicant level into quartiles and the odds ratio for abnormal ALT was determined after adjusting for confounding variables like age, sex, race, BMI, and insulin resistance (HOMA score) using logistic regression analysis. Results: 4582 subjects were included in the analysis. Of these, 34.1% were found to have abnormal ALT. Several organochlorine pesticides (or metabolites) including dieldrin, oxychlordane, trans-nonachlor, and heptachlor epoxide were associated with a dose-dependent increased risk for ALT elevation. Among heavy metals, lead, mercury, and thallium also demonstrated a dose-dependent increased risk for ALT elevation. Conclusions: In the US population, exposures to specific organochlorine pesticides and heavy metals are associated with a dose-dependent increased risk for otherwise unexplained liver disease. Although most of these organochlorine pesticides are no longer used, they are persistent pollutants which appear to be clinically relevant. The pathogenic role of these toxicants in liver diseases such as NAFLD should be explored. Acknowledgement: The authors would like to acknowledge the AASLD Sheila Sherlock Award (Cave), NIH (McClain), and the National Institute of Environmental Health Sciences (P30ES01444301A1) (Brock) for their support of this research.