title: The impact of hepatitis C virus infection on long-term outcome in renal transplant patients.
abstract: OBJECTIVE
  The aim of this study was to determine the effect of hepatitis C virus infection on patient and graft survival and liver function in renal transplant patients.
  
  
  METHODS
  1811 renal transplant patients were included in this study. One hundred renal transplant patients (5.5%) were anti-hepatitis C virus-positive. We evaluated demographic, clinical, biochemical, and serological data of patients and compared patient and graft survivals between hepatitis C virus-positive and -negative renal transplant patients.
  
  
  RESULTS
  The median follow-up period was 35.7 months. One hundred (5.5%) patients were anti-hepatitis C virus-positive. There were no differences between anti-hepatitis C virus-positive and -negative renal transplant patients regarding age, etiology of renal disease, number of pre-transplant blood transfusions, and hepatitis B virus coinfection rate. Rate of graft loss in anti-hepatitis C virus-positive renal transplant patients was significantly higher than in anti-hepatitis C virus-negative patients (16.0% vs. 9.2%, p=0.026). Survival analysis revealed that patient survival was similar between anti-hepatitis C virus-positive and -negative renal transplant patients. Graft survival was lower in the anti-hepatitis C virus-positive group than in anti-hepatitis C virus-negative patients, especially after the fifth year of renal transplant (p<0.001). Thirty-three percent of anti-hepatitis C virus-positive patients were positive for hepatitis C virus RNA. Twenty-seven percent of anti-hepatitis C virus-positive patients had persistent alanine aminotransferase elevation. None of the patients developed cirrhosis during the follow-up period.
  
  
  CONCLUSIONS
  Our findings suggest that hepatitis C virus infection in renal transplant patients does not adversely affect patient survival. Long-term graft survival seems to be lower in hepatitis C virus-positive compared to hepatitis C virus-negative renal transplant patients. Nevertheless, renal transplant can be considered as a safe and effective treatment modality in anti-hepatitis C virus-positive patients with end-stage renal disease.
authors.affiliation: Department of Internal Medicine, Akdeniz University, School of Medicine, Antalya, Turkey.
authors.forename: Çağlar
authors.initials: Ç
authors.lastname: Ruhı
authors.forename: İnci
authors.initials: İ
authors.lastname: Süleymanlar
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Koçak
authors.forename: Vural Taner
authors.initials: VT
authors.lastname: Yilmaz
authors.forename: Dilek
authors.initials: D
authors.lastname: Çolak
authors.forename: Ayhan
authors.initials: A
authors.lastname: Dınçkan
authors.forename: Alihan
authors.initials: A
authors.lastname: Gürkan
authors.forename: Fevzi
authors.initials: F
authors.lastname: Ersoy
authors.forename: Gülşen
authors.initials: G
authors.lastname: Yakupoğlu
authors.forename: Gültekin
authors.initials: G
authors.lastname: Süleymanlar
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D019698:Hepatitis C, Chronic / Q000401:mortality*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality*; D008111:Liver Function Tests; D008297:Male; D015995:Prevalence; D006435:Renal Dialysis / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors