Chronic hepatitis B and C in renal graft recipients

• Published in: Vestnik Rossiĭskoĭ akademii medits︠i︡nskih nauk no. 11; p. 49
• Main Authors: Zubkin, M L, Balakirev, E M, Chervinko, V I, Zolotarevskiĭ, V B, Baranova, F S, Taranov, V A, Bakulin, I G, Stanke, A A, Evseev, A A, Novozhenov, V G
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2006
• Subjects: Adolescent; Adult; Aged; Biopsy; Female; Follow-Up Studies; Hepacivirus - immunology; Hepatitis B Antibodies - immunology; Hepatitis B virus - immunology; Hepatitis B, Chronic - etiology; Hepatitis B, Chronic - pathology; Hepatitis B, Chronic - virology; Hepatitis C Antibodies - immunology; Hepatitis C, Chronic - etiology; Hepatitis C, Chronic - pathology; Hepatitis C, Chronic - virology; Humans; Kidney Failure, Chronic - surgery; Kidney Transplantation - adverse effects; Kidney Transplantation - pathology; Male; Middle Aged; Postoperative Complications; Prognosis; Risk Factors
• ISSN: 0869-6047

Clinical and morphological features of chronic hepatitis B (CHB), C (CHC), and B+C (CHB+C) were studied in 283 renal graft recipients. High total bilirubin serum levels were detected significantly more often in CHB and CHB+C patients vs. CHC patients. High ALT activity was noted in 65% of CHB patients and only in 45% of CHC patients (p = 0.003). Stable low activity of hepatitis prevailed in renal recipients; it was noted in 56.7% of CHB patients, 66.2% of CHC patients, and 62% of CHB+C patients. The character of pathomorphological liver changes in chronic viral hepatitis was studied in 53 renal graft recipients using puncture biopsy. Histopathological activity index (HAI, Knodell R.G. et al., 1981) witnessed a more severe liver lesion in CHB vs. CHC and CHB+C. Thus, inflammatory activity in CHB was found to be minimal or low in 13 patients, and moderate or high in 11 patients, whilst a minimal or low activity in CHC or CHB+C was found in 16 and 10 patients, respectively, and a moderate activity was detected only in two and one, respectively (p = 0.016 and 0.024 compared with CHB). Advanced hepatic fibrosis or cirrhosis was significantly more frequent (p = 0.006) in CHB patients (eight out of 24) than in CHC ones (none out of 18). The rate of advanced sclerotic changes in CHB+C was lower (one out of 10 patients) than that in CHB, and similar to CHC. Thus, clinico-morphological manifestations were more prominent in renal graft recipients with CHB vs. CHC.