Hepatitis in renal transplant recipients

Abstract

The prevalence of parentally transmitted hepatotropic virus infection (HVI) varies in different centers and in different parts of the world. It correlates with the prevalence in the dialysis and the general population and with the selection bias of using organs from infected donors and accepting infected recipients for transplantation. With the adoption of effective procedures that reduce nosocomial exposure and with the availability of effective vaccines, the prevalence of hepatitis B virus (HBV) among RTR has been declining steadily over the last decades. This trend, however, is more obvious in the United States and Europe but less so in Asia. This is because of the high prevalence rate of HBV infection in the general population in Asia. With a declining prevalence of HBV infection, hepatitis C virus (HCV) has become the most prevalent HVI among RTR. In selected studies reported in the 1990s in which prevalences of both HBV and HCV among RTR area available, the rate varies from 4 to 32% for HBV and 6 to 49% for HCV. Hepatitis G (GBV-C) virus (HGV) is a recently identified parentally transmitted virus. It has a prevalence rate of between 44 to 55% and is therefore as common as HCV among RTR, but studies so far have failed to demonstrate a significant independent impact of HGV on liver biochemistry and histology and on patient or graft survival. Hepatitis D virus (HDV superinfection in HBV-infected RTR is uncommon and infrequently reported.