Chronic liver disease in kidney recipients with hepatitis C virus infection

Abstract

In this series the prevalence of anti-HCV positive is 51.7%. Most of the patients presented liver damage in histology caused by HCV. However, we found only mild or minimal fibrosis and inflammatory activity grade, despite 10 yr of HCV infection and 5 yr of immunosuppressive treatment. Only one patient presented cirrhosis (4%). Performing serial liver biopsies in a long-term follow-up is needed to clarify the impact of HCV infection in renal transplant patients.

Epidemiological aspects of hepatitis C virus infection among renal transplant recipients in Central Brazil

“…In addition, a length of time on hemodialysis of more than three years (adjusted OR = 11.9; 95% CI: 2.3-61.8) and renal transplantation before 1994 (adjusted OR = 20.2; 95% CI: 4.6-87.5) were strongly associated with HCV infection. As observed elsewhere, while the first risk factor reinforces the hemodialytic environment as source of HCV dissemination in this population (Morales & Campistol 2000, Corrêa et al 2003, Giordano et al 2003, Aroldi et al 2005, Pedroso et al 2006, Gheith et al 2007), the latter clearly shows the impact of anti-HCV screening in candidates for blood and organ donations (Abbott et al 2005, Carneiro et al 2005, Fabrizi et al 2007). Among the HCV-positive patients studied, renal transplantation was performed in 16 (39%) subjects between 1982 and 1993, prior to the beginning of anti-HCV screening for candidate blood and organ donors/recipients in Brazil.…”

“…The prevalence of HCV infection of 16.1% found in these patients in GO is almost 12 times greater than that observed among local blood donors (1.4%) (Martins et al 1994). Nevertheless, relative to other Brazilian renal transplant recipient populations, this prevalence is lower than those reported in the cities of Porto Alegre (33%) (Corrêa et al 2003) and Campinas (54%) (Giordano et al 2003); it was, however, in accordance with those carried out in other countries, where rates have been found to range from 7.2% to 63.8% (Fehr et al 2003, Mitwalli et al 2006). In addition, the prevalence among RTP we determined is similar to that reported for hemodialysis patients in GO (16.4%) ).…”

“…In addition, genotype 1, subtype 1a was also predominant in RTP in Campinas (Giordano et al 2003) and in hemodialysis patients in the cities of São Paulo (Moreira et al 2003, Perez et al 2003, Recife (Albuquerque et al 2005) and Campo Grande (Freitas et al 2008), and in the states of Tocantins (Souza et al 2003) and GO (Espírito-Santo et al 2007). These data suggest that this subtype is more likely to disseminate in a hemodialysis environment.…”

“…Furthermore, the genotyping of HCV isolates is a useful tool for establishing the source of outbreaks in hemodialysis centers and other nosocomial settings (Zein 2000, Simmonds et al 2005 The prevalence of HCV infection has been reported to range from 7.2% among renal transplant recipients (RTP) in Switzerland to 63.8% in Saudi Arabia (Mitwalli et al 2006, Fehr et al 2003. In Brazil, a continental country, epidemiological data concerning HCV infection in renal transplant patients are still rare (Corrêa et al 2003, Giordano et al 2003, and little is known about the genetic diversity of HCV isolates in these patients (Giordano et al 2003, Perez et al 2003. In this study, the prevalence of HCV infection among RTP in Central Brazil was estimated and risk factors associated with HCV infection in this population were analyzed.…”

Natural History of Hepatitis C Virus-Related Liver Fibrosis After Renal Transplantation

“…In that population, the prevalence of cirrhosis ranges from 4% to 22% (1)(2)(3)(4)(5). In contrast to the findings of Zylberberg et al (3), we have recently found that the progression rate of liver fibrosis was lower in HCV(+) RT patients compared with that observed in HCV(+) immunocompetent patients (4).…”