Impact of hepatitis C virus infection on kidney transplant outcome

Abstract EN

One hundred and forty kidney transplant recipients were evaluated to study the impact of hepatitis C virus (HCV) infection on patient and graft outcome.

There .were 98 males arid 42 females with a mean age of 32.1 ± 13 years.

The duration of follow-up ranged from 6-60 months with a mean period of 27.8 ± 18.2 months.

Seventy-four (53%) patients had received cadaveric kidneys while 66 (47%) received living donor grafts.

Anti-HCV reactivity was tested using second generation enzyme-linked immunosorbent assay and positivity was confirmed by recombinant immunoblot assay.

HCV infection was diagnosed in 29 cases (20.7%) while HBsAg was found in nine (6.4%) and concomitant anti-HCV and HBsAg positivity was observed in two patients (1.4%).

Seventeen of 29 (58.6%) patients with anti-HCV reactivity showed elevated ALT levels as against 17 of 111 (17.3%) anti-HCV non-reactive patients (P<0.001).

There was no association between the sex of the patient, source of the graft, and anti-HCV reactivity.

Serum creatinine values were higher in the anti-HCV positive group, but this did not rank to statistical significance.

We observed a significantly higher graft loss among the anti-HCV reactive group (27.6% versus 1.8%, P< 0.003).

Thirteen anti-HCV reactive patients were subjected to 18 liver biopsies; the commonest lesion observed was chronic active hepatitis, which was progressive in two patients subjected to re-biopsy.

We conclude that HCV infection is a serious health problem among kidney transplant recipients and it significantly affects the graft outcome.