title: Long-term impact of renal transplantation on liver fibrosis during hepatitis C virus infection.
abstract: OBJECTIVE
  During hepatitis C virus (HCV) infection, liver fibrosis progression after renal transplantation remains controversial. The aim of this cohort study with controls was to compare liver histopathologic features during HCV infection between renal transplant recipients and matched groups of hemodialyzed patients or controls without renal disease and untreated for HCV.
  
  
  METHODS
  Each renal transplant recipient (group 1, n = 30) was matched at first liver biopsy (LB) using the main factors known to influence progression of fibrosis with one HCV hemodialyzed patient (group 2, n = 30) and one HCV-infected patient (nonhemodialyzed, nontransplanted; group 3, n = 30). Patients from group 1 were also matched with those of group 3 on the time between 2 consecutive LBs performed 37 months apart. LBs were evaluated according to the Knodell index, METAVIR score, and rate of fibrosis progression per year (fibrosis unit).
  
  
  RESULTS
  The rate of fibrosis progression per year between the first and second LBs was significantly lower (P = 0.03) in group 1 (0.067; 95% confidence interval: -0.05, 0.18) than group 3 (0.20; 95% confidence interval: 0.13, 0.26). At the second LB, the Knodell index and activity or fibrosis in METAVIR were lower in group 1 than group 3 (4.2 +/- 0.4 vs. 7.5 +/- 0.6, 0.5 +/- 0.1 vs. 1.3 +/- 0.2, and 1.4 +/- 0.2 vs. 2.3 +/- 0.2 respectively, P < 0.01).
  
  
  CONCLUSIONS
  Our study suggests that liver fibrosis progression is low in most HCV-infected renal transplant recipients with moderate liver disease at baseline.
authors.affiliation: Service de Médecine Interne, Pavillon Dieulafoy, CHU Purpan, Toulouse, France. ALRIC.L@chu-toulouse.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Alric
authors.forename: Vincent
authors.initials: V
authors.lastname: Di-Martino
authors.forename: Janik
authors.initials: J
authors.lastname: Selves
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
authors.forename: Frédéric
authors.initials: F
authors.lastname: Charlotte
authors.forename: Didier
authors.initials: D
authors.lastname: Reynaud
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Piette
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Péron
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Vinel
authors.forename: Dominique
authors.initials: D
authors.lastname: Durand
authors.forename: Jacques
authors.initials: J
authors.lastname: Izopet
authors.forename: Thierry
authors.initials: T
authors.lastname: Poynard
authors.forename: Michel
authors.initials: M
authors.lastname: Duffaut
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
mesh_terms: D000328:Adult; D001706:Biopsy; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000601:surgery* / Q000628:therapy; D016030:Kidney Transplantation; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology* / Q000821:virology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012720:Severity of Illness Index