568 ASCITES IN LIVER TRANSPLANT RECIPIENTS WITH RECURRENT HEPATITIS C IN THE ABSENCE OF ADVANCED FIBROSIS: IMPACT OF CRYOGLOBULINEMIA

Abstract

the 454 GS-FLX platform (Roche). Viral complexity was measured by mutation frequency and genetic diversity. Results: Successive expansions and contractions of quasispecies were observed, evolving in all cases towards a more homogeneous population, with a relatively low genetic variability. In patients 1, 3 and 5, the donor population outcompeted the recipient virus immediately after LT (day1), whereas in cases 2, 4 and 6, the recipient virus overtook the donor’s. In all cases, the most complex viral population excluded the other and became dominant. In cases 1, 2, 4 and 6, minority mutants derived from the donor or the recipient were detected at various points after LT regardless of the final result of the in vivo competition. Interestingly, in case 2, viral coexistence lasted even after the first year after LT. Conclusions: Our results show that during superinfection with a different HCV strain in the LT, the viral population with the highest diversity always outcompetes the other and becomes dominant. The exclusion of non-dominant can take place as early as the first day or after several months following LT. However, the excluded virus may remain as a minority population (even after 1 year) and could emerge if there were any changes in the environment.