Chronic liver disease in kidney recipients with hepatitis C virus infection.
BACKGROUND
The prevalence of anti-hepatitis C virus (HCV) positive test is higher among patients in dialysis and in kidney recipients than in general population. Hepatitis C virus infection is the main cause of chronic liver disease in renal transplant patients. Liver biopsy and virological analysis were performed to clarify the grade of liver damage in kidney recipients.


METHODS
Renal recipients patients with at least 5 yr under immunosuppression were submitted to clinical and laboratory analysis. Patients who tested anti-HCV positive were candidates to liver biopsy with no regard to transaminase levels.


RESULTS
Forty-five patients tested anti-HCV positive and 42 anti-HCV negative. Twenty-six anti-HCV and RNA-HCV positive patients were submitted to liver biopsy. Seventy-three percentage of these patients presented chronic active hepatitis, from these only one patient presented cirrhosis. Only 29% of the anti-HCV positive group presented elevated alanine aminotransferase levels. Anti-HCV positive patients presented longer previous time on dialysis and less rejection episodes than the group anti-HCV negative (p < 0.05). All anti-HCV positive patients but one tested RNA-HCV positive by polymerase chain reaction (PCR).


CONCLUSIONS
In this series the prevalence of anti-HCV positive is 51.7%. Most of the patients presented liver damage in histology caused by HCV. However, we found only mild or minimal fibrosis and inflammatory activity grade, despite 10 yr of HCV infection and 5 yr of immunosuppressive treatment. Only one patient presented cirrhosis (4%). Performing serial liver biopsies in a long-term follow-up is needed to clarify the impact of HCV infection in renal transplant patients.
Giordano
Helena M
HM
Department of Gastroenterology, State University of Campinas, São Paulo, Brazil. giordanovalerio@uol.com.br
França
Alex V C
AV
Meirelles
Luciana
L
Escanhoela
Cecília A F
CA
Nishimura
Nancy F
NF
Santos
Raquel L S
RL
Quadros
Kélcia R S
KR
Mazzali
Marilda
M
Alves-Filho
Gentil
G
Soares
Elza C
EC
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001706:Biopsy; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D018937:Hepatitis C Antibodies / Q000032:analysis*; D019698:Hepatitis C, Chronic / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D008099:Liver / Q000473:pathology*; D008297:Male; D016133:Polymerase Chain Reaction; D013997:Time Factors
D018937:Hepatitis C Antibodies; D000410:Alanine Transaminase