Histopathological impacts of hepatitis virus infection in hemodialysis patients: should liver biopsy be performed before renal transplantation?
To evaluate the histologic changes in the livers of renal transplant candidates who were infected with hepatitis viruses, we performed a percutaneous liver biopsy in each of 74 regular hemodialysis patients. Forty percent of them were seropositive for the antibody to hepatitis C virus (anti-HCV) whereas 29.7% had anti-HCV and antibody to hepatitis B surface antigen (anti-HBs) concomitantly. Seven (9.5%) were seropositive for only hepatitis B surface antigen HBsAg. Histopathological examination revealed that 30% of patients had chronic active hepatitis (CAH), 11% had chronic persistent hepatitis (CPH), and 3% displayed histopathological evidence of cirrhosis. Eleven of 22 patients with CAH were positive for only anti-HCV, and 2 of 22 were positive for only HBsAg. One patient had HBsAg and anti-HCV together, and 8 of 22 had anti-HBs and anti-HCV concomitantly. None of the anti-HBs positive patients exhibited abnormal histopathological changes. We found no statistically significant difference in histopathological findings between the HBsAg positive and anti-HCV positive patients. As 32 of 74 patients (43%) had some degree of chronic liver disease, we concluded that it is prudent to evaluate liver histology in HBsAg and anti-HCV seropositive renal transplant candidates before transplantation.
Ozdoğan
M
M
Department of Internal Medicine, Baskent University, School of Medicine, Ankara, Turkey.
Ozgür
O
O
Gür
G
G
Boyacioğlu
S
S
Ozderin
Y
Y
Demirhan
B
B
Telatar
H
H
Haberal
M
M
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016174:Hepacivirus / Q000276:immunology / Q000378:metabolism; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology; D006526:Hepatitis C / Q000473:pathology* / Q000503:physiopathology; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D016030:Kidney Transplantation; D008099:Liver / Q000473:pathology* / Q000821:virology; D008103:Liver Cirrhosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies