Hepatitis C in the Kidney Transplant Recipients at Choray Hospital - South Vietnam

Abstract

Background: Hepatitis C virus (HCV) infection is common cause of cirrhosis and hepatic cancer. HCV Contaminated incidence in Vietnam about 4-10%. 85% HCV infection cases become chronic infection. In RT patients, HCV is mainly cause of progressive liver diseases and death. So that, a research about evolution of hepatitis C in RT is necessary. Purposes: This study aimed to evaluate the epidemiologic, ratio, clinical and laboratory aspect of hepatitis C and also analyze the outcome of hepatitis C on the group of the kidney transplant recipients who are following at Cho Ray hospital- South Viet Nam. Subjects and methods: This is a case study was performed from January 1992 to December 2009 at Cho Ray hospital. All of kidney transplant recipients was tested SGOT,SGPT and anti HCV at the first admission to looking for hepatitis C. if anti HCV positive, next step was perform HCV DNA to definitive diagnosis hepatitis C (only from 1993 to now). All of kidney transplant recipients with hepatitis C will be follow up on hepatic functions every month, abdominal echography, fibroscan every year and PCR was performed every year on hepatitis C and anytime necessary. Diagnostic criteria: HCV RNA (+) and/or anti HCV (+) Analysis soft wear: by Epi-info softwear -Version 2007 It included 22 hepatitis C in 433 kidney transplant recipients. Results: 1. The rate of hepatitis C was 5.08% (22/433 kidney transplant recipients). It includes 16 pts hepatitis C infection alone and 6 pts coinfection with HBV and HAV. Male is 81.8% and average age is 49yrs. Means follow up time is 6.4yrs (1 to 18yrs) 2. 8 cases were performing kidney transplantation at Viet Nam and 100% of them received kidney from their relative. 14 cases was perform kidney transplantation at other country and ratio of them received kidney from their relative only was 7.14%. Further more, patient has hepatitis C before take RT was 50%, and 81. 8% of them from other countries. 3. Increased transaminase levels was observed in 40.9% RT pts HCV infection 4. Serum diagnosis test: Anti HCV (+) and HCV RNA (+): 20/22 (90%) Anti HCV (-) and HCV RNA (+): 2/22 (10%) 5. Fibro scan test: 17 patients with hepatitis C were evaluated by fibro scan: F0: 2cases (11. 7%) F1: 9cases (52.9%) F2: 3cases (17.6%) F3: 3cases (17.6%) 6. Accompany diseases consist of diabetes and hypertension was presented in 36.3% and 100% of patients respectively. 7. Immune depressions regiment: CsA+Prednisone+Azathioprine 3 cases (13.6%) CsA+prednisone+MMF 14cases (63.6%) FK506+MMF+Prednisone 5cases (22.7%) 8. Specific treatment: One case hep.C was treated interferon before RT and follow up in 3 years after with SRV (sustain virus response) Conclusion: Hepatitis C was 5.08% in RT group at Choray hospital- VN. (It was 2% in USA and was 9% in India). Increased transaminase levels were observed in 40.9%. Patient have hep.C before take RT was 50%, and 81,8% of them from other country. Common accompany diseases consist of diabetes and hypertension.