Hepatitis C virus antibody status and survival after renal transplantation: meta-analysis of observational studies.
The natural history of hepatitis C virus (HCV) among patients after renal transplantation (RT) remains incompletely defined. We conducted a systematic review of the published medical literature on the impact of hepatitis C antibody status on survival of patients who received RT. We used the random effects model of DerSimonian and Laird to generate a summary estimate of the relative risk (RR) for mortality and graft loss with HCV seropositivity across the published studies. We identified eight clinical trials (6365 unique patients); six (75%) were cohort studies and two (2/8 = 25%) controlled trials, respectively. Pooling of study results demonstrated that presence of anti-HCV antibody was an independent and significant risk factor for death and graft failure after RT; the summary estimate for RR was 1.79 (95% CI, 1.57-2.03; homogeneity test, p = 0.0427) and 1.56 (95% CI, 1.35-1.80; homogeneity test, p = 0.0192), respectively. As a cause of death, hepatocellular carcinoma (HCC) and liver cirrhosis were significantly more frequent among anti-HCV positive than anti-HCV negative RT patients. This meta-analysis demonstrates that RT recipients with anti-HCV antibody have an increased risk of mortality and graft failure compared with HCV antibody negative patients.
Fabrizi
Fabrizio
F
Division of Nephrology and Dialysis, Maggiore Hospital, IRCCS, Milano, Italy. fabrizi@policlinico.mi.it
Martin
Paul
P
Dixit
Vivek
V
Bunnapradist
Suphamai
S
Dulai
Gareth
G
D000328:Adult; D005260:Female; D006085:Graft Survival; D016174:Hepacivirus / Q000276:immunology*; D006526:Hepatitis C / Q000401:mortality*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors
D018937:Hepatitis C Antibodies