title: Histological evolution of hepatitis C virus infection after renal transplantation.
abstract: BACKGROUND
  information regarding histological progression of hepatitis C after renal transplant (RTx) is scarce.
  
  
  OBJECTIVE
  To analyze clinical and laboratory evolution and histological progression of hepatitis C in patients evaluated before and after RTx.
  
  
  METHODS
  Twenty-two HCV-infected patients submitted to liver biopsy pre- and post-RTx were included. A semiquantitative analysis of necroinflammatory activity and fibrosis staging was performed and the two biopsies were compared.
  
  
  RESULTS
  Patients were mostly men (73%) with mean age of 36±9 yr. Time post-transplant was 4±2 yr and time between biopsies was 5±2 yr. An elevation of alanine aminotransferase (p=0.041) and aspartate aminotransferase (p=0.004) levels was observed in the post-transplant period. Fibrosis progression after renal transplantation was observed in 11 (50%) of the patients, and necroinflammatory activity worsening was observed in 7 (32%) of the patients. The histological progression occurred even among those without significant histological lesions in pre-transplant biopsy.
  
  
  CONCLUSIONS
  The findings of this study suggest that the practice of indicating treatment in the pre-transplant phase based mainly on histological disease should be revised, because a high proportion of patients present disease progression. Because interferon cannot be used safely after RTx, treatment should be indicated for all ESRD patients with hepatitis C.
authors.affiliation: Division of Gastroenterology, Universidade Federal de São Paulo, Brazil. siuehara@gmail.com
authors.forename: Silvia Naomi
authors.initials: SN
authors.lastname: de Oliveira Uehara
authors.forename: Christini Takemi
authors.initials: CT
authors.lastname: Emori
authors.forename: Patrícia
authors.initials: P
authors.lastname: da Silva Fucuta Pereira
authors.forename: Renata M
authors.initials: RM
authors.lastname: Perez
authors.forename: José Osmar Medina
authors.initials: JO
authors.lastname: Pestana
authors.forename: Valéria Pereira
authors.initials: VP
authors.lastname: Lanzoni
authors.forename: Ivonete Sandra Souza
authors.initials: IS
authors.lastname: e Silva
authors.forename: Antonio Eduardo Benedito
authors.initials: AE
authors.lastname: Silva
authors.forename: Maria Lucia Cardoso Gomes
authors.initials: ML
authors.lastname: Ferraz
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D016174:Hepacivirus / Q000472:pathogenicity*; D019698:Hepatitis C, Chronic / Q000209:etiology / Q000473:pathology* / Q000821:virology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology* / Q000821:virology; D008137:Longitudinal Studies; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate