A prospective study of hepatitis C virus infection among renal transplant recipients.
BACKGROUND
Chronic non-A, non-B hepatitis is a major cause of liver disease in renal transplant recipients.


METHODS
One hundred eight-five renal allograft recipients, including 151 who had been prospectively followed up for 24 months, were studied to determine the prevalence and course of hepatitis C virus (HCV) infection. Antibody to HCV (anti-HCV) was measured by enzyme immunoassay, and HCV RNA was measured by nested polymerase chain reaction assay.


RESULTS
Twenty-three (12.4%) patients were positive for anti-HCV and/or HCV RNA: 19 (10.3%) were anti-HCV positive; and HCV RNA was detected in 18 (94.7%) anti-HCV-positive and 4 (2.4%) anti-HCV-negative patients. Markers of HCV infection persisted in all HCV-positive patients over the 2-year period. Most HCV-positive patients acquired HCV infection before or at the time of transplantation. The incidence of new infection after transplantation was 0.45% per patient-year. Anti-HCV and/or HCV RNA was detected in 75% of patients with biochemical chronic non-A, non-B hepatitis, but transaminase levels were persistently normal in 30.4% of HCV-positive individuals.


CONCLUSIONS
HCV infection is common among renal transplant recipients. Testing for HCV RNA is important because some patients might not produce anti-HCV. Transaminase levels cannot be used as a surrogate marker of HCV infection in these patients.
Chan
T M
TM
Department of Medicine, University of Hong Kong, Queen Mary Hospital.
Lok
A S
AS
Cheng
I K
IK
Chan
R T
RT
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006508:Hepatitis Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006526:Hepatitis C / Q000382:microbiology*; D018937:Hepatitis C Antibodies; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors
D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D000410:Alanine Transaminase