Impact of hepatitis C infection on renal transplant patients : a single-center experience in Libya

Abstract EN

The objective of this study was to assess the effect of hepatitis C virus (HCV) infection on graft and patient survival in a cohort of Libyan renal transplant recipients.

Medical records of 241 renal transplant (RT) patients who have been followed-up at the Benghazi Nephrology Center up to February 2010 were reviewed.

Based on the presence or absence of anti-HCV antibodies and HCV-RNA in the serum, patients were divided into two groups: HCV-positives and HCV-negatives.

Anti-HCV antibodies were detected by the enzyme-linked immunosorbent assay technique and HCV-RNA by the polymerase chain reaction.

Of the 241 RT patients, 162 were male and 79 were female.

One hundred and ten patients (45.6 %) were HCV-positives and 131 (54.4 %) were HCV-negatives.

Acute graft rejection was significantly higher among HCV-negative than HCV-positive patients (42 patients versus 28 patients, respectively; P < 0.001).

Conversely, chronic graft rejection was higher among HCV-positives than that among HCV-negative patients (35 patients versus 24 patients, respectively; P < 0.05), and this difference became more significant after a 12-month period of transplantation (P < 0.01).

Seventeen patients died during the follow-up: Seven HCV-positives (6.3 %) and 10 HCV-negatives (7.6 %), and there was no significant difference in the death rate following RT between the two groups (P = 0.08).

Among the seven deaths of HCV-positives, liver disease-related complications were the main cause of death in three (42.8 %) HCV-positive patients compared with none in the HCV-negative patients.

The presence of HCV infection influenced chronic graft survival in RT patients and a higher proportion of HCV-infected patients had hepatic dysfunctions after RT.

An increase in fatal liver complications was noted in HCVpositive patients with RT.

In addition to pre-RT-specific therapy of HCV infection, all measures should be taken to prevent HCV infection pre- and post-RT.

HCV-infected RT recipients need close monitoring for graft and liver function to prolong allograft and patient survival.