HBV and HCV infections in heart transplant recipients.
BACKGROUND
Heart transplant (HTx) recipients risk acquiring hepatotropic viral infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV), and the impact of these infections on post-HTx survival remains unclear. The aim of the present study was to define the prevalence, clinical features, and natural history of HBV and HCV infections in a cohort of HTx recipients.


METHODS
We retrospectively studied 360 consecutive patients who had undergone HTx. Clinical picture, hepatic injury indexes, and HBV/HCV viral serology were followed post-transplant.


RESULTS
During follow-up (average, 8 +/- 3.1 years), 49 (16.5%) of the HTx recipients tested positive for at least 1 of the 2 viruses (3.1% HBV, 12% HCV, 0.5% concomitant infection). The prevalence of HCV infection in heart transplant recipients transplanted before and after 1990 was 28% and 4.2%, respectively, the latter being markedly lower (p < 0.001) than in earlier series of HTx recipients and much lower than expected in the age- and sex-matched general population. All HBV-positive and 58% of HCV-positive recipients developed chronic liver disease. Sixteen percent of patients developed cirrhosis during follow-up, and 8% died of end-stage liver disease.


CONCLUSIONS
The prevalence of HBV and HCV in a large population of HTx recipients is not very different from that reported in the general population. Active viral replication of HBV and an aggressive natural history of both infections are seen in HTx recipients, however. The low prevalence of HBV- and HCV-related infection in recent series probably reflects current viral screening and vaccination policies.
Fagiuoli
S
S
Department of Surgical and Gastroenterological Sciences,University of Padova, Padova, Italy. fagiuoli@ux1.unipd.it
Minniti
F
F
Pevere
S
S
Farinati
F
F
Burra
P
P
Livi
U
U
Naccarato
R
R
Chiaramonte
M
M
D000328:Adult; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D016174:Hepacivirus / Q000302:isolation & purification; D006508:Hepatitis Antibodies / Q000097:blood; D018963:Hepatitis Antigens / Q000097:blood; D006509:Hepatitis B / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006515:Hepatitis B virus / Q000302:isolation & purification; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008099:Liver / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D015996:Survival Rate; D014761:Viral Hepatitis Vaccines / Q000627:therapeutic use
D006508:Hepatitis Antibodies; D018963:Hepatitis Antigens; D014761:Viral Hepatitis Vaccines