title: The Effect of Hepatitis B Virus on Graft and Overall Survival in Kidney Transplant Patients.
abstract: OBJECTIVE
  We investigated the effect of hepatitis B virus in kidney transplant patients in terms of patient care and survival.
  
  
  METHODS
  We retrospectively analyzed kidney transplant patients from 1993 to 2013. A control group with negative serology was selected. The hepatitis B virus-positive group was divided into 2 subgroups based on serologic status, treatments, and treatment responses. Group A had viral suppression, and group B had hepatitis B virus DNA persistence. Overall and allograft survival rates were compared.
  
  
  RESULTS
  We identified 32 hepatitis B virus-positive and 74 hepatitis B virus-negative patients. Positive group was treated with lamivudine (n = 23), lamivudine plus entecavir (n = 4), lamivudine plus tenofovir (n = 4), or lamivudine plus entecavir and tenofovir (n = 1). In group A (n = 15), antiviral treatment was given based on the presence of either hepatitis B surface antigen with negative hepatitis B virus DNA (n = 11) or hepatitis B virus DNA positivity (n = 4). Group B patients (n = 17) received antiviral treatment for persistence of hepatitis B virus DNA (n = 7) or for viral reactivation (ie, recurrence of hepatitis B virus DNA) (n = 10). Groups A and B did not differ significantly in terms of graft or overall survival. Liver biopsy was performed in 17 patients; 3 patients had high-grade fibrosis or cirrhosis, and 14 patients had normal histology or mild hepatitis. Median graft survival time was longer in positive group (69.5 mo vs 54 mo; P = .007). Five- and 10-year overall survival rates were comparable (89%-84% vs 96%-96%; P = .107).
  
  
  CONCLUSIONS
  Hepatitis B virus-positive kidney transplant patients have increased liver transaminase levels, longer graft survival times, and similar median overall survival rates compared with hepatitis B virus-negative patients.
authors.affiliation: From the Department of Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Harmancı
authors.forename: Sena
authors.initials: S
authors.lastname: İlin
authors.forename: Serkan
authors.initials: S
authors.lastname: Öcal
authors.forename: Murat
authors.initials: M
authors.lastname: Korkmaz
authors.forename: Gökhan
authors.initials: G
authors.lastname: Moray
authors.forename: Turan
authors.initials: T
authors.lastname: Çolak
authors.forename: Haldun
authors.initials: H
authors.lastname: Selçuk
authors.forename: B Handan
authors.initials: BH
authors.lastname: Özdemir
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D006085:Graft Survival; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D006515:Hepatitis B virus / Q000187:drug effects / Q000472:pathogenicity*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents