title: Natural history of hepatitis C virus-related liver fibrosis after renal transplantation.
abstract: The aim of our study was to assess hepatitis C virus (HCV) evolution and long-term liver histology outcome in anti-HCV(+)/RNA(+) renal transplant (RT) patients. A total of 51 anti-HCV(+)/RNA(+) RT patients underwent liver biopsies (LB) every 3-4 years after transplantation (two LBs, n = 51; three LBs, n = 42; four LBs, n = 9). The hypervariable region (HVR)-1 of the HCV genome from all patients was characterized over time. Overall, the rate of liver fibrosis progression was 0.09 +/- 0.03 Metavir units/year. We identified three groups of patients: those in whom liver fibrosis remained stable (n = 21), those with progressing liver fibrosis (n = 21) and those with a regression in liver fibrosis (n = 10). In the last two groups, the progression and the regression of liver fibrosis were gradual during follow-up. Ferritin levels and hepatosiderosis were significantly higher in fibrosers. Initial fibrosis stage and high diversification of the HVR-1 of HCV genome between transplantation and the first liver biopsy were independent factors associated with liver fibrosis regression. In conclusion, in the current study, more than 10 years after renal transplantation, HCV infection was not harmful upon liver histology in more than 50% of patients. The diversification of the HVR-1 might be used to predict liver fibrosis outcome.
authors.affiliation: Department of Nephrology, Dialysis and Multiorgan Transplantation, CHU Rangueil, Toulouse, Paris, France. nassim.kamar@free.fr
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
authors.forename: Janick
authors.initials: J
authors.lastname: Selves
authors.forename: Karine
authors.initials: K
authors.lastname: Sandres-Saune
authors.forename: Laurent
authors.initials: L
authors.lastname: Alric
authors.forename: Dominique
authors.initials: D
authors.lastname: Durand
authors.forename: Jacques
authors.initials: J
authors.lastname: Izopet
mesh_terms: D000328:Adult; D019943:Amino Acid Substitution; D005260:Female; D005293:Ferritins / Q000097:blood; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000150:complications* / Q000821:virology; D006801:Humans; D007501:Iron / Q000378:metabolism; D007668:Kidney / Q000503:physiopathology; D016030:Kidney Transplantation; D008099:Liver / Q000201:enzymology / Q000378:metabolism / Q000473:pathology; D008103:Liver Cirrhosis / Q000201:enzymology* / Q000378:metabolism / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012367:RNA, Viral / Q000097:blood; D014764:Viral Proteins / Q000235:genetics
chemical_list: C400562:HVR1 protein, Hepatitis C virus; D012367:RNA, Viral; D014764:Viral Proteins; D005293:Ferritins; D007501:Iron