title: Hepatitis C virus in kidney recipients. Epidemiology and impact on renal transplantation.
abstract: In an attempt to evaluate the prevalence, kinetics and impact of HCV infection in renal transplantation, we analyzed 140 kidney recipients according to the histopathological status of the liver. Thirty-three HBsAg-negative patients had chronic active hepatitis, 73 HBsAg-negative patients had a normal liver, 21 HBsAg-negative kidney recipients had minimal pathological changes and 13 patients had HBsAg-positive cirrhosis. Serum antibodies to HCV were detected using the ELISA from Ortho Diagnostic and confirmatory tests using the Ortho recombinant-based immunoblot assays. The overall prevalence of antiHCV antibodies was 23.6%. AntiHCV were more frequently present in HBsAg-negative patients with chronic active hepatitis (60.6%) than in HBsAg-negative patients with normal livers (8.2%) (p less than 0.0001) or minimal liver changes (33.3%) (NS) or in HBsAg-positive patients with cirrhosis (0%) (p less than 0.001). The recombinant-based immunoblot assays confirmed antiHCV-positive ELISA results in 86.7% of patients. Among the 27 antiHCV-positive kidney recipients who had serial serological follow-up, 10 (37.0%) were already positive at transplantation and remained antiHCV-positive during follow-up. Eleven patients (40.8%) acquired antiHCV an average of 95 months after renal transplantation, while antiHCV disappeared an average of 111 months after transplantation in six (22.2%), who had antiHCV prior to transplantation. The kinetics of antiHCV antibodies did not differ according to liver histology. Patient and graft survival were not different in antiHCV-positive and antiHCV-negative kidney recipients irrespective of liver histology, and there was no difference in survival between antiHCV-positive and antiHCV-negative patients with chronic hepatitis.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Département de Néphrologie Adulte, Hôpital Necker, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Pol
authors.forename: C
authors.initials: C
authors.lastname: Legendre
authors.forename: C
authors.initials: C
authors.lastname: Saltiel
authors.forename: F
authors.initials: F
authors.lastname: Carnot
authors.forename: C
authors.initials: C
authors.lastname: Bréchot
authors.forename: P
authors.initials: P
authors.lastname: Berthelot
authors.forename: B
authors.initials: B
authors.lastname: Mattlinger
authors.forename: H
authors.initials: H
authors.lastname: Kreis
mesh_terms: D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006084:Graft Rejection; D016174:Hepacivirus / Q000276:immunology / Q000302:isolation & purification; D006508:Hepatitis Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006526:Hepatitis C / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D006801:Humans; D015151:Immunoblotting; D016030:Kidney Transplantation / Q000009:adverse effects*; D008099:Liver / Q000382:microbiology / Q000473:pathology; D008297:Male; D015995:Prevalence
chemical_list: D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens