Hepatitis C antibody after kidney transplantation: clinical significance.
The prevalence of antibodies to hepatitis C virus (HCV) was investigated in 231 renal transplantation recipients, by a first- and second-generation EIA assay and a second-generation immunoblot assay (4-RIBA). Before transplantation, prevalence of anti-HCV was 22.6% and was related to the time on dialysis (p < 0.01), transfusions (p < 0.01) and previous history of chronic liver disease (p < 0.01. Following transplantation, 32 patients (13.9%) were anti-HCV positive by the first-generation enzyme immunoassay (EIA) and it increased to 57 patients (24.7%) when anti-HCV was measured by the second-generation EIA. The 4-RIBA assay confirmed the positivity in 46 patients (80.7%), 11 patients (19.3%) were indeterminate. Seroconversion after grafting was observed in 7 negative patients, and another 7 patients became negative after the procedure. The presence of anti-HCV antibody after transplantation was determined by the patient status on dialysis, 80% of them being positive before surgery. Twenty-one 4-RIBA-positive transplantation patients (45.7%) had persistently or intermittently abnormalities on liver function tests, suggesting chronic liver disease. A liver biopsy performed on 10 of these patients showed; chronic active hepatitis in 6, chronic persistent hepatitis in 2, and chronic lobular hepatitis in the other 2 patients. Another 23 4-RIBA-positive transplantation patients had normal alanine aminotransferase levels despite long follow-up (66.2 +/- 32.2 months). The prevalence of anti-HCV antibody can be underestimated if the antibody is measured by first-generation EIA alone. About 50% of patients with anti-HCV had chronic liver disease, and the histological findings suggested a possible evolution to cirrhosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Marcen
R
R
Department of Nephrology, Hospital Ramón y Cajal, Madrid, Spain.
Gamez
C
C
Mateos
M L
ML
Orofino
L
L
Teruel
J L
JL
Serrano
P
P
Pascual
J
J
Quereda
C
C
Nash
R
R
Ortuño
J
J
D000328:Adult; D005260:Female; D016174:Hepacivirus / Q000276:immunology; D006505:Hepatitis / Q000175:diagnosis / Q000209:etiology; D006508:Hepatitis Antibodies / Q000032:analysis*; D018937:Hepatitis C Antibodies; D006801:Humans; D015151:Immunoblotting; D007124:Immunoenzyme Techniques; D016030:Kidney Transplantation; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies
D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies