Impact of Hepatitis C Virus Infection on Kidney Transplantation

Abstract

Hepatitis C virus (HCV) infection increases morbimortality in renal transplantation. Hepatitis C virus positive kidney transplant candidates who remain on the waiting list show a greater risk of mortality than those who are transplanted. The aim of this study was to examine the impact of HCV infection on patient and allograft survival after kidney transplantation. Eighty two patients with end stage renal disease underwent kidney transplantation were included in this study. The patients were classified into group I including 46 HCV negative patients (HCV-) and group II including 36 HCV antibody and HCV-RNA positive patients (HCV+). The immunosuppressive protocols were similar in both groups. All recipients were followed up for 3years.Results: There were statistically insignificant differences (P>0.05) between both groups as regard age, gender and donor type (living related or unrelated). Hemodialysis duration before transplantation was highly significant (P 0.05); 2 grafts (4.3%) lost in HCV- group and 3 (8.3%) in HCV+ group with also insignificant difference (P>0.05). Five recipients (10.9%) in group I experienced delayed graft function compared to 2 (5.6%) recipients in group II with statistically insignificant difference. There was a significantly (P< 0.05) more number of acute rejection episodes among HCV+ patients (11=30.6%) than HCV- patients (5=10.9%).New onset diabetes mellitus occurred more among HCV+ (19.4%) than HCV- (8.7%) recipients, however the difference was insignificant. There was a significant (P<0.05) higher incidence of cytomegalovirus disease among HCV+ (11.1%) than HCV- (2.2%) recipients. Conclusion: This study suggested that HCV positivity does not significantly affect patient and graft survival despite the significant increased incidence of acute rejection episodes and cytomegalovirus disease. Lastly, all measures should be taken to prevent HCV transmission in dialysis population.