Evolution of the Hypervariable Region-1 of Hepatitis C Virus and Liver Fibrosis Progression in Renal-Transplant Recipients

Lack of Impact of Hepatitis C Virus Infection on Graft Survival After Kidney Transplantation—A Portuguese Single-Center Experience

“…In a subgroup analysis of risk factors for graft loss in the HCV-positive population, we found that, similarly to the general population, HCVpositive patients receiving transplants because of interstitial kidney disease were at greater risk for graft loss, and azathioprine was associated with a protective effect. Consistently with earlier reports [22,23], an additional finding was that a protective effect of CsA (aHR, 0.080; 95% CI, 0.009e0.755; P ¼ .027) on the renal grafts was found exclusively in the HCV-positive transplants. Indeed, CsA was the elected immunosuppressive regimen in our HCV-positive sample, and, with its associated protective effect, this might explain the good graft survival (compared with the control population) among our HCV-positive patients.…”

“…CsA was shown to inhibit HCV viral replication in cultured hepatocytes, and HCVpositive KT recipients treated with CsA showed stabilization and regression in liver fibrosis in >50% of the cases [22,23]. As a result of those earlier studies, our center's immunosuppressive protocol preferred the use of CsA on HCV-infected patients undergoing KT.…”

“…Data were collected from the medical reports, either on paper or electronic charts. Our center preferred the use of cyclosporine (CsA) as primary immunosuppressant in HCV-positive patients owing to previous reports that claimed stabilization and regression of fibrosis in HCV-positive patients recipients by decreasing viral replication [22,23]. Adult patients (age, 18 years), submitted to 1 KT procedure, and who were serologically found to be HCV antibody positive and had positive viral load (during a minimum 6-month period) were selected as the study/case group.…”