Hepatitis B and hepatitis C virus infection and outcome of hemodialysis and kidney transplant patients.
OBJECTIVE
A comparison of the outcome of hepatitis virus-positive and -negative kidney transplant and hemodialysis patients was the aim of this investigation.


METHODS
The study involved 384 kidney transplant patients (67 HBsAg positive, 39 anti-HCV positive, 278 hepatitis negative), transplanted between 1987 and 2001, and 403 hemodialysis patients (128 HBsAg positive, 83 anti-HCV positive, 192 hepatitis negative) who had started hemodialysis and were referred to the kidney transplant waiting list during the same period.


RESULTS
Hemodialysis patients were older than transplant patients. Comparison of the groups' survival rates, adjusted for patient age, showed that all kidney transplant patients survived longer than hemodialysis patients (p < 0.001). HBV infection had a negative impact on patient survival, especially in hemodialysis patients. HCV infection did not have a significant influence on patient survival. Cardiovascular disease was the main cause of death of all hemodialysis- and hepatitis-negative transplant patients. Liver failure was one of the leading causes of death in HBV-positive transplant patients. Mortality risk was higher for older patients, HBV-positive and -negative hemodialysis patients.


CONCLUSIONS
Kidney transplantation offers longer survival for hepatitis-positive and -negative hemodialysis patients. HBV but not HCV infection had a negative impact on ESRD patient survival.
Lezaic
Visnja
V
Department of Nephrology, Clinical Center of Serbia, Beograd, Serbia. visnjal@eunet.yu
Visnja
Lezaic
L
Stosovic
Milan
M
Milan
Stosovic
S
Marinkovic
Jelena
J
Jelena
Marinkovic
M
Rangelov
Vanja
V
Vanja
Rangelov
R
Djukanovic
Ljubica
L
Ljubica
Djukanovic
D
D000328:Adult; D002423:Cause of Death; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy* / Q000821:virology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D015996:Survival Rate; D016896:Treatment Outcome