title: Lack of impact of hepatitis C virus infection on graft survival after kidney transplantation--a Portuguese single-center experience.
abstract: BACKGROUND
  Hepatitis C virus infection (HCV) is a common problem among kidney transplant (KT) recipients. The long-term burden of HCV infection on graft survival after kidney transplantation is controversial.
  
  
  METHODS
  We performed a retrospective study including all renal transplant recipients with HCV infection (n = 34) compared with a control group (n = 80). The prevalence of HCV infection was 2.7%. The median follow-up period was 134 months (11 years). Graft survival and associated risk factors were assessed by means of Cox proportional hazard analysis.
  
  
  RESULTS
  We found that HCV-positive patients remained on dialysis for longer periods (P = .001) and received transplants at a younger age (P = .03). Actuarial graft survival rates at 1, 5, and 10 years after KT were, respectively, 94.1%, 78.1%, and 66.9%, in the HCV-positive group and 94.9%, 89.1%, and 80.4% in the HCV-negative group. Graft survival did not differ significantly between groups (P = .154). A higher incidence of major cardiovascular disease among HCV-positive patients (P = .004) was noted. Multivariate analysis showed that HCV infection was not an important risk factor for graft loss (adjusted hazard ratio, 2.810; 95% confidence interval, 0.925-8.541; P = .069). Among the HCV-positive population, immunosuppression with cyclosporine or azathioprine conveyed better graft survival.
  
  
  CONCLUSIONS
  Our findings suggest that the long-term impact of HCV infection on graft survival after KT is not significant. KT remains a safe and effective modality of renal replacement in HCV-infected patients with end-stage renal disease.
authors.affiliation: Gastroenterology Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal. Electronic address: pmagalhaescosta@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Magalhães-Costa
authors.affiliation: Gastroenterology Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
authors.forename: L
authors.initials: L
authors.lastname: Lebre
authors.affiliation: Nephrology and Renal Transplantation Department, Hospital Santa Cruz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
authors.forename: D
authors.initials: D
authors.lastname: Machado
authors.affiliation: Gastroenterology Department, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Chagas
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D002318:Cardiovascular Diseases; D016022:Case-Control Studies; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery* / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011174:Portugal; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine