title: Impact of hepatitis C virus infection on bone mineral density in renal transplant recipients.
abstract: BACKGROUND
  The average prevalence of hepatitis C virus (HCV) infection in renal transplant recipients is 10%. Studies of these patients with HCV infection usually focuses on long-term graft survival and patient survival. Studies of the correlation between HCV infection and bone mineral density (BMD) in renal transplant patients are limited. The aim of this study was to investigate whether HCV infection is a risk factor for BMD change during a short follow-up period.
  
  
  METHODS
  Seventy-six renal transplant recipients underwent 2 separate dual-energy X-ray absorptiometry (DXA) scans during a mean period of 14 months. Fifteen patients were HCV infection. First bone mineral density (BMD) at the lumbar spine, hip, and femoral neck was determined using dual-energy X-ray absorptiometry (DXA) between September 2008 and March 2009. After that, 34 patients took alendronate sodium 70 mg per week. Subgroups risk factors analysis was also performed into with or without alendronate. Immunosuppressive agents, bisphosphonates, patient characteristics, and biochemical factors were analyzed to identify associations with BMD.
  
  
  RESULTS
  After 14 months, in 76 patients, BMD of the lumbar spine had significantly increased (from 0.9 g/cm² to 0.92 g/cm², p<0.001), whereas BMD of the hip and femoral neck had not. Multiple linear regression analysis showed that HCV infection was negatively associated with BMD change in the lumbar spine ( β: -0.247, 95% CI, -0.035 to -0.002; p = 0.028). Moreover, in subgroup analysis, among 42 patients without alendronate, multiple linear regression analysis showed HCV infection was a risk factor for adverse BMD change of the lumbar spine ( β: -0.371, 95% CI, -0.043 to -0.003; p = 0.023).
  
  
  CONCLUSIONS
  HCV infection in renal transplant recipients was a negative risk factor for BMD change in the lumbar spine. Moreover, alendronate may be able to reverse the negative effect of HCV infection on bone in renal transplant recipients.
authors.affiliation: Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan, R.O.C.
authors.forename: Wen-Hung
authors.initials: WH
authors.lastname: Huang
authors.forename: Mei-Ching
authors.initials: MC
authors.lastname: Yu
authors.forename: Jeng-Yi
authors.initials: JY
authors.lastname: Huang
authors.forename: Ping-Chin
authors.initials: PC
authors.lastname: Lai
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D019386:Alendronate / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology* / Q000821:virology; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D050071:Bone Density Conservation Agents; D007166:Immunosuppressive Agents; D019386:Alendronate