Post-transplant diabetes mellitus and HCV seropositive status after renal transplantation: meta-analysis of clinical studies.
Hepatitis C virus (HCV) infection has a detrimental role on patient and graft survival after renal transplantation (RT). Some studies have also implicated HCV in the development of post-transplant diabetes mellitus (PTDM). We conducted a systematic review of the published medical literature of the relationship between anti-HCV seropositive status and DM after RT. The risk of DM occurrence in anti-HCV-positive and -negative patients after RT was regarded as the most reliable outcome end-point. We used the random effects model of DerSimonian and Laird to generate a summary estimate of the Odds Ratio (OD) of new onset DM in HCV-positive and -negative patients after kidney transplantation. Ten studies involving 2502 unique RT recipients were identified. The incidence of PTDM after RT ranged between 7.9% and 50%. The summary estimate for adjusted OR was 3.97 with a 95% confidence interval (CI) of 1.83-8.61 (p-value for homogeneity <0.0473). Thus, pooling of study results demonstrated the presence of a significant link between anti-HCV seropositive status and DM after RT. This relationship provides one potential explanation for the adverse effects of HCV on patient and graft survival after RT.
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
Kanwal
Fasiha
F
Dulai
Gareth
G
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D006085:Graft Survival; D006526:Hepatitis C / Q000209:etiology*; D018937:Hepatitis C Antibodies / Q000276:immunology; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011897:Random Allocation; D012107:Research Design; D012189:Retrospective Studies; D012306:Risk; D013997:Time Factors; D016896:Treatment Outcome
D018937:Hepatitis C Antibodies