Harmful long-term impact of hepatitis C virus infection in kidney transplant recipients.
BACKGROUND
The long-term impact of hepatitis C virus (HCV) infection in renal transplant recipients remains controversial. We report here our experience, in a homogeneous single center, of 499 patients with a fairly long follow-up.


METHODS
We retrospectively studied 499 hepatitis B virus-negative patients who received an initial cadaver donor kidney transplantation at Necker Hospital between January 1, 1979 and December 31, 1994, with a graft or patient survival of at least 6 months. Anti-HCV antibodies were detected at time of transplantation in 112 patients (22%). Patient survival and causes of death were compared among anti-HCV-positive and -negative patients


RESULTS
Our results clearly indicate that first cadaver kidney transplant recipients with anti-HCV antibodies had a significantly shorter patient and graft long-term survival than recipients without anti-HCV antibodies (P<0.01 and P<0.0001 respectively). Mean follow-up time after transplantation was 79+/-2 months in the former group and 81+/-5 months in the latter (NS). Increased mortality was primarily caused by liver disease (P<0.001) and sepsis (P<0.01). In a multivariate analysis, HCV infection significantly affected the mortality rate (odds ratio: 2.8).


CONCLUSIONS
These results suggest that HCV infection has a harmful long-term impact on the survival of kidney transplant recipients.
Legendre
C
C
Service de Transplantation, Hôpital Necker, Paris, France.
Garrigue
V
V
Le Bihan
C
C
Mamzer-Bruneel
M F
MF
Chaix
M L
ML
Landais
P
P
Kreis
H
H
Pol
S
S
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D016030:Kidney Transplantation; D008297:Male; D016019:Survival Analysis; D013997:Time Factors
D018937:Hepatitis C Antibodies