Hepatitis C virus infection after renal transplantation.
Hepatitis C virus (HCV) infection is the main cause of liver disease after renal transplantation. Most patients have seroconverted on dialysis to positive RNA. The viral load increases during immunosuppressive therapy. The risk of developing chronic liver disease is related to the histopathologic findings, duration and severity of the disease, immunosuppression, and transplantation time. Hepatitis C virus infection can predict onset, of proteinuria and diabetes. We studied 868 patients who received renal transplants between (1987 and 2006), of whom 18.7% were seropositive for HCV. We observed a higher rate of HCV-seropositive patients related to the duration of hemodialysis therapy. Of the HCV seropositive patients, 77% had received renal allografts before 1998. There was no difference between the sexes; however, the HCV positive patients were younger. Polymerase chain reaction tests results were positive in 91.6% of the patients with HCV antibodies. The prevalence of diabetes was greater among HCV positive patients, as was as the persistence of proteinuria. Cryoglobulins were positive in 30.8%. The incidence of acute rejection episodes in the first year was similar between groups. Of the HCV-positive patients, 80.2% were treated with cyclosporine, most patients continued this therapy throughout the study. We observed no significant difference in mortality end graft survival rate between the two groups. However, renal function differed significantly at some points during the evolution of the clinical course. Renal transplantation is still the best treatment option in patients with chronic renal disease.
Romero
E
E
Nephrology Service of "Virgen de las Nieves" Universitary Hospital, Granada, Spain. eromeroramirez@gmail.com
Galindo
P
P
Bravo
J A
JA
Osorio
J M
JM
Pérez
A
A
Baca
Y
Y
Ferreira
C
C
Asensio
C
C
Osuna
A
A
D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival / Q000502:physiology; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000473:pathology; D008297:Male; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D015996:Survival Rate