The clinical outcome of hepatitis C virus antibody-positive renal allograft recipients

• Published in: Transplantation Vol. 53; no. 4; p. 763
• Main Authors: Huang, C C, Liaw, Y F, Lai, M K, Chu, S H, Chuang, C K, Huang, J Y
• Format: Journal Article
• Language: English
• Published: United States 01.04.1992
• Subjects: Adult; Female; Hepacivirus - immunology; Hepatitis Antibodies - analysis; Hepatitis B Surface Antigens - analysis; Hepatitis C - etiology; Hepatitis C Antibodies; Humans; Kidney Transplantation - adverse effects; Male; Prevalence; Transplantation, Homologous
• ISSN: 0041-1337; 1534-6080
• DOI: 10.1097/00007890-199204000-00011

In order to investigate the prevalence of antibody to hepatitis C virus (anti-HCV) in renal transplant patients, the evolution of anti-HCV status, and clinical outcome in anti-HCV-positive renal allograft recipients, we tested the sera from 120 renal transplant patients for anti-HCV. Thirty-eight patients were hepatitis B surface antigen (HBsAg)-positive. Two patients were anti-delta-positive. A total of 79 patients (65.8%) had at least one serum positive for anti-HCV. Anti-HCV positivity decreased after transplantation for more than 5 years (65.5% at transplantation versus 37.9%, 78.3 +/- 13.4 months later). Among those with positive anti-HCV, the HBsAg-positive group had significantly higher incidence of chronic hepatitis (50% vs. 25.5%, P = 0.026) and liver cirrhosis (21.4% vs. 0%, P = 0.001) than HBsAg-negative group. Among the 82 HBsAg-negative patients, the prevalence of anti-HCV was significantly higher in those with chronic hepatitis than in those without (86.7% vs. 56.7%, P = 0.027). We conclude from this study: (1) anti-HCV positivity is quite prevalent in renal transplant patients; (2) coinfection of hepatitis B virus (HBV) and hepatitis C virus (HCV) may lead to aggressive liver disease and cirrhosis; HCV infection alone has a more benign clinical outcome; and (3) HCV infection is an important cause of posttransplant chronic hepatitis in HBsAg-negative patients.