Natural History of Hepatitis C Virus Infection in Adult Renal Graft Recipients

To study the natural history of hepatitis C virus infection in renal transplantation, 464 HbsAg negative patients were prospectively studied from 1989. AntiHCV was tested by ELISA II and HCVRNA by Amplicor HCV RNA tests. Two hundred nine patients were antiHCV positive (C+). HCVRNA was confirmed in 8...

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Bibliographic Details
Published in:Transplantation proceedings 2005-03, Vol.37 (2), p.940-941
Main Authors: Aroldi, A., Lampertico, P., Montagnino, G., Lunghi, G., Passerini, P., Villa, M., Campise, M., Cesana, B.M., Ponticelli, C.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cause of Death
Chi-Square Distribution
Drug Therapy, Combination
Enzyme-Linked Immunosorbent Assay
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Graft Survival
Hepatitis C - physiopathology
Hepatitis C Antibodies - blood
Human viral diseases
Humans
Immunosuppressive Agents - therapeutic use
Infectious diseases
Kidney Transplantation - mortality
Kidney Transplantation - physiology
Liver Failure - etiology
Liver Failure - mortality
Medical sciences
Recurrence
RNA, Viral - isolation & purification
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Survival Analysis
Tissue, organ and graft immunology
Viral diseases
Viral hepatitis
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Summary:To study the natural history of hepatitis C virus infection in renal transplantation, 464 HbsAg negative patients were prospectively studied from 1989. AntiHCV was tested by ELISA II and HCVRNA by Amplicor HCV RNA tests. Two hundred nine patients were antiHCV positive (C+). HCVRNA was confirmed in 89% of C+ patients. Compared with the 255 anti-HCV negative (C−), C+ had undergone longer periods of dialysis ( P = .0001), were more transfused ( P = .01), and included more retransplants ( P = .002). Immunosuppression was azathioprine (AZA) plus steroids in 133 and cyclosporine (CsA) in 331 patients. Liver biopsy showed chronic active hepatitis in 50, cirrhosis in 8, and fibrosing cholestatic hepatitis in 2 patients. Histologic progression of liver disease was confirmed in 18 of 26 patients. The causes of death in 84 patients (51 C+ vs 33 C−) were cardiovascular disease in 49%, sepsis in 13%, liver failure in 14%, neoplasia in 21%, and hepatocarcinoma in 2%. The 14-year patient survival was 75% in C+ and 86% in C− ( P = .002). By multivariate analysis, age (>40) ( P = .001) and C+ ( P = .019) correlated with a worse patient survival. If patients were stratified according to age (
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2004.11.068