[Long-term consequences of co-infection by hepatitis G virus in hepatitis c virus infected kidney transplant patients].
The objectives of this retrospective study were to determine the prevalence of hepatitis G virus (HGV) infection in hepatitis C virus positive (HCV+ve) renal transplant (RT) patients and to evaluate the impact of HGV both on liver function tests, liver histology tests and renal parameters such as the prevalence of acute rejection and renal function. Seventy-one HCV+ve renal transplant patients with a functioning graft for whom a post renal transplant liver biopsy was available, were included. Serum HGV RNA was assessed by reverse transcription polymerase chain reaction before, at the time of, and after renal transplantation. A total of 21 (30%) of the HCV+ve RT patients had a positive HGV RNA (Group 1); seventeen of these patients (81%) were already HGV RNA+ve when the most recent renal transplantation was performed. The other 4 patients became HGV RNA+ve following renal transplantation. The mean duration of HGV infection was at least 119 +/- 64 months (18-240). Patients in group 1 did not statistically differ from the 50 HGV RNA-ve/HCV+ve RT patients (Group 2) according to sex ratio; time on dialysis; number of blood transfusions; HLA matching; the duration of HCV infection; duration and type of immunosuppression or levels of liver enzymes i.e. aspartate aminotransferase, alanine aminotransferase and gamma glutamyl transpeptidase; serum HCV RNA concentration; or frequency of genotype 1b. However, Group 1 patients were statistically younger (41 +/- 10 y compared to 47 +/- 10 y; p = 0.016) than Group 2 patients. Liver histology showed a significantly lower degree of fibrosis in Group 1 (0.4 +/- 0.5) than in Group 2 (1 +/- 1.2; p = 0.02); two patients from Group 2 but none of Group 1 had overt cirrhosis. Conversely, the extent of hepatic inflammation and hepatocellular necrosis was not statistically different between the two groups. The number of patients who experienced at least one acute rejection episode was significantly higher in Group 1 (76.2%) than in Group 2 (46%; p = 0.02), although the difference was no longer significant in the multivariate analysis. In conclusion, this study shows that: i) HGV infection was often present when the patients seroconverted for HCV; ii) HGV RNA+ve/HCV+ve RT patients experience acute rejection more frequently than HGV RNA-ve/HCV+ve RT patients; iii) HGV infection seems to have no detrimental effect upon liver enzymes or liver histology in HCV+ve RT patients.
Service de néphrologie, Centre hospitalier régional de Toulouse.
L
L
Rostaing
J
J
Izopet
C
C
Arnaud
J L
JL
Rumeau
M
M
Duffaut
J M
JM
Cisterne
D
D
Durand
D000328:Adult; D005260:Female; D018067:Flaviviridae / Q000302:isolation & purification; D006084:Graft Rejection / Q000453:epidemiology; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications*; D006525:Hepatitis, Viral, Human / Q000150:complications*; D006801:Humans; D016030:Kidney Transplantation / Q000473:pathology / Q000502:physiology*; D008099:Liver / Q000473:pathology / Q000821:virology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies
D012367:RNA, Viral
Conséquences à long terme d'une surinfection par le virus de l'hépatite G chez des transplantés rénaux infectés par le virus de l'hépatite C.