Co-infection by hepatitis B virus and hepatitis C virus in renal transplantation: morbidity and mortality in 1098 patients

Publisher Website
Google Scholar
Abstract
The aim of the study was to analyse the influence of co-infection by hepatitis B virus (HBV) and hepatitis C virus (HCV) as compared with HCV infection alone in 1098 patients who received a kidney transplant between 1 January and 31 December 1991. At transplantation, the prevalence of anti-HCV antibodies was 21.40% (235/1098) while the prevalence of HBV infection was 9.85% (108/1096); 46 patients were co-infected with HBV and HCV, either 19.70% of HCV-infected patients and 42.60% of HBV-infected patients. Liver tests, galactose clearance and liver biopsy were compared in the 46 co-infected patients (HCV + HBV + ) and in the 189 HCV-infected patients (HCV + HBV − ). At the time of transplantation, cytolysis was present in 31.45% of HCV + HBV − patients (50/159) and in 40% of HCV + HBV − patients (16/40); cholestasis was present in 34.18% of HCV + HBV − patients (34/158) and 42.11% of HCV + HBV + patients (16/38). At 6 months the incidence of biological abnormalities increased to 37% in HCV + HBV − patients (55/150) and to 52.5% in HCV + HBV − patients (21/40), suggesting a more deleterious effect of the immunosuppressive therapy in the co-infected group. Over the course of transplantation, chronic hepatitis was present in 50% of HCV + HBV − patients and in 64.1% of HCV + HBV + patients. Liver failure occurred in 7% of HCV + HBV − patients (12/156) and 17% of HCV + HBV + patients (7/41). Galactose clearance was performed as a functional test in 68 patients: it was not significantly different in either group. Liver biopsy was performed in 108 patients at least once. Minimal changes were more frequent in HCV + HBV − patients while the incidence of cirrhosis was 10% in HCV + HBV − patients (8/81) and 26% in HCV + HBV + patients (7/27). Serum HCV RNA detected by polymerase chain reaction was present in 81% of the HCV + HBV − patients (43/53) and 70% of the HCV + HBV + patients (14/20). Patient survival rate was not significantly different in both groups at 12 years.

This publication has 0 references indexed in Scilit: