title: Impact of hepatitis C virus infection on kidney transplant outcome.
abstract: One hundred and forty kidney transplant recipients were evaluated to study the impact of hepatitis C virus (HCV) infection on patient and graft outcome. There .were 98 males arid 42 females with a mean age of 32.1 +/- 13 years. The duration of follow-up ranged from 6-60 months with a mean period of 27.8 +/- 18.2 months. Seventy-four (53%) patients had received cadaveric kidneys while 66 (47%) received living donor grafts. Anti-HCV reactivity was tested using second generation enzyme-linked immunosorbent assay and positivity was confirmed by recombinant immunoblot assay. HCV infection was diagnosed in 29 cases (20.7%) while HBsAg was found in nine (6.4%) and concomitant anti-HCV and HBsAg positivity was observed in two patients (1.4%). Seventeen of 29 (58.6%) patients with anti-HCV reactivity showed elevated ALT levels as against 17 of 111 (17.3%) anti-HCV non-reactive patients (P< 0.001). There was no association between the sex of the patient, source of the graft, and anti-HCV reactivity. Serum creatinine values were higher in the anti-HCV positive group, but this did not rank to statistical significance. We observed a significantly higher graft loss among the anti-HCV reactive group (27.6% versus 1.8%, P< 0.003). Thirteen anti-HCV reactive patients were subjected to 18 liver biopsies; the commonest lesion observed was chronic active hepatitis, which was progressive in two patients subjected to re-biopsy. We conclude that HCV infection is a serious health problem among kidney transplant recipients and it significantly affects the graft outcome.
authors.affiliation: Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
authors.forename: O I
authors.initials: OI
authors.lastname: Alfurayh
authors.forename: M A
authors.initials: MA
authors.lastname: Sobh
authors.forename: T S
authors.initials: TS
authors.lastname: Chaudry
authors.forename: W Y
authors.initials: WY
authors.lastname: Qunibi
authors.forename: K
authors.initials: K
authors.lastname: Al Meshari
authors.forename: M
authors.initials: M
authors.lastname: Ellis
authors.forename: M A
authors.initials: MA
authors.lastname: Ali
authors.forename: S
authors.initials: S
authors.lastname: Taher