title: A role for chronic parvovirus B19 infection in liver dysfunction in renal transplant recipients?
abstract: BACKGROUND
  Clinically, liver dysfunction in renal transplant recipients is related to hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. The contribution of parvovirus B19 (B19) to liver disease in renal transplant recipients has not been studied. Here we present the association of liver dysfunction with or without the coinfection of B19, HBV, and HCV after renal transplantation.
  
  
  METHODS
  We used enzyme-linked immunosorbent assay to identify B19, HBV, and HCV infections in serum samples taken from 144 renal transplant recipients before transplantation and at 12 and 24 months after transplantation. After each patient had fasted for 12 hr, blood was taken for measurement of aspartate aminotransferase and alanine aminotransferase monthly for at least 6 months.
  
  
  RESULTS
  Liver dysfunction developed at the significantly higher incidence of 47% in the anti-HCV(+) patients compared with 6% in the noninfected group (P<0.0001). HBV infection had no impact on the incidence of liver dysfunction in renal transplant recipients. A higher incidence of liver dysfunction was found in 42% of B19 IgG(+)IgM(-) group patients compared with 13% of the B19 IgG(+)IgM(+) group (P=0.0051) and 9.5% of the B19 IgG(-)IgM(-) group (P=0.0003). A B19 polymerase chain reaction (PCR) assay revealed significantly higher liver dysfunction in 29% of B19 PCR(+) group patients compared with 13.6% of B19 PCR(-) patients (P=0.0419). Patients who were anti-HCV(+) and B19 PCR(+) had a significantly higher incidence of liver dysfunction than B19 PCR(-) patients (P=0.002).
  
  
  CONCLUSIONS
  Chronic B19 infection and HCV infection, both separately and in combination, increase the incidence of liver dysfunction in renal transplant recipients. HBV infection does not seem to be independently or synergistically associated with liver dysfunction.
authors.affiliation: Department of Surgery, College of Medicine, National Cheng Kung University, Tainan, Taiwan. pochang@mail.ncku.edu.tw
authors.forename: Po-Chang
authors.initials: PC
authors.lastname: Lee
authors.forename: Chung-Jye
authors.initials: CJ
authors.lastname: Hung
authors.forename: Yih-Jyh
authors.initials: YJ
authors.lastname: Lin
authors.forename: Jen-Ren
authors.initials: JR
authors.lastname: Wang
authors.forename: Ming-Shiou
authors.initials: MS
authors.lastname: Jan
authors.forename: Huan-Yao
authors.initials: HY
authors.lastname: Lei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002648:Child; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology*; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D008107:Liver Diseases / Q000209:etiology / Q000821:virology*; D008111:Liver Function Tests; D008875:Middle Aged; D010322:Parvoviridae Infections / Q000209:etiology* / Q000503:physiopathology; D016732:Parvovirus B19, Human / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D011183:Postoperative Complications / Q000821:virology*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase