Short communication Serum levels of ¢brosis biomarkers measured early after liver transplantation are associated with severe hepatitis C virus recurrence D. Micheloud 1 , M. Salcedo 2,3 , R. Ban˜ ares 2,3 , D. Rinco´n 2,3 , R. Lorente 4 , M.A. Mun˜oz- Ferna´ ndez 4 , S. Resino 1 1 Unidad de Investigacio´n, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain, 2 Unidad de Trasplante Hepa´ tico, Hospital General Universitario ‘Gregorio Maran˜o´n,’ Madrid, Spain, 3 Centro de Investigacio´n Biome´dica en Red de Enfermedades Hepa´ticas y Digestivas (Ciberehd), Spain, 4 Laboratorio de Inmuno-Biologı ´a Molecular, Hospital General Universitario ‘Gregorio Maran˜o´n,’ Madrid, Spain D. Micheloud, M. Salcedo, R. Ban ì ares, D. Rinco¤ n, R. Lorente, M.A. Mun ì oz-Ferna¤ ndez, S. Resino. Serum levels of ¢brosis biomarkers measured early after liver transplantation are associated with severe hepatitis C virus recurrence. Transpl Infect Dis 2009: 11: 183^188. All rights reserved Abstract: This prospective study analyzed the relationship between several biological markers related to liver ¢brosis at 3 months and 1year post liver transplantation in 37 patients (19 with hepatitis C virus [HCV],18 with alcoholic liver disease). Severe HCVrecurrence (HCV-SR) was de¢ned as ¢brosis stage  F1 (METAVIR score) at 1year and/or a value of hepatic venous pressure gradient  6 mmHg. We found HCV- SR patients had higher values of monocyte chemotactic protein-1 (MCP-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and hyaluronic acid (HA) than non-severe HCVrecurrence patients ( Po0.05). Moreover, receiver operating characteristic curve analysis showed that interferon- inducible protein 10 (IP-10) (area under the curve [AUC]: 0.74; con¢dence interval [CI] 95%: 0.49^0.91; P 5 0.043), MCP-1 (AUC: 0.78; CI 95%: 0.54^ 0.94; P 5 0.007), sVCAM-1 (AUC: 0.89; CI 95%: 0.67^0.98; P 5 0.005), and HA (AUC: 0.80; CI 95%: 0.55^0.94; P 5 0.035) have good predictive capacity for identifying severe HCV infection. The evaluation of these biomarkers may be useful in the early identi¢cation of patients in whom a more aggressive therapeutic approach could be necessary.                                                                                                     Hepatitis C virus (HCV) infection is the leading cause of chronic liver disease and the most common indication for liver transplantation (LT) (1). However, HCV viremia per- sists and recurrence of chronic hepatitis can be demon- strated as early as 4 weeks after LT (2). Although the severity of recurrent HCV is highly variable, persistent infection is frequently associated with progressive ¢brosis (3, 4). Several serum markers, such as growth factors, cyto- kines, chemokines, adhesion molecules, hyaluronic acid (HA), matrix metalloproteinases and their inhibitors, have been associated with ¢brosis in HCV-infected patients who have not undergone LT (5). The aim of our study was to an- alyze the relationship between early expression (3 months post LT) of a serum panel of biological markers related to progression of liver damage and severityof HCVrecurrence at 1 year after LT. Patients and methods We carried out a prospective study on 37 patients who re- ceived acadaveric livergraft from February 2002 to Decem- ber 2005. Nineteen patients received LT for HCVcirrhosis, all of whom were infected by genotype 1. Eighteen patients had alcoholic cirrhosis, and they were used as a control group of LT (without HCV recurrence). Recurrence of HCV infection after LTwas con¢rmed by the presence of serum HCV RNA assessed by polymerase chain reaction. The study was approved by the Institutional Ethics Committee and all patients gave their written informed consent to par- ticipate in the study. Immunosuppressive therapy was based on tacrolimus or cyclosporine along with steroids according to local proto- r 2009 John Wiley & Sons A/S Transplant Infectious Disease . ISSN 1398-2273 Key words: predictive serum markers; chemokines; cytokines; angiogenesis; endothelial adhesion; hepatitis C; liver transplantation; fibrosis; biomarkers Correspondence to: Salvador Resino, Unidad de Investigacio´n, Instituto de Salud Carlos III (Campus Majadahonda), Carretera Majadahonda- Pozuelo, Km 2.2, 28220 Majadahonda, Madrid, Spain Tel: 1 34 918 223 266 Fax: 1 34 915 097 946 E-mail: sresino@isciii.es Received 16 July 2008, revised 8 September 2008, accepted for publication 2 October 2008 DOI: 10.1111/j.1399-3062.2009.00370.x Transpl Infect Dis 2009: 11: 183–188 183