Hepatitis B Virus and Renal Transplantation

Fabrizi, Fabrizio; Martin, Paul; Ponticelli, Claudio

doi:10.1159/000049058

Cited by 29 publications

(26 citation statements)

References 50 publications

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“…HBV infection have been reported to account for a significant portion of patient mortality in RTRs because of complications such as chronic liver disease, liver cirrhosis, hepatoma and hepatic failure [2][3][4][5][6][7][8][9]. Fornairon et al [7] performed serial liver biopsies in 151 RTRs with positive HBsAg and showed that cirrhosis developed in Besides the host factors, virological factors have been associated with a higher risk of LC or HCC in chronic HBV patients.…”

Section: Discussionmentioning

confidence: 99%

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The role of HBV genotype core promoter and precore mutations in advanced liver disease in renal transplant recipients

Tsai

Chen

Lee

et al. 2009

Journal of Hepatology

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Section: Discussionmentioning

confidence: 99%

“…Chronic liver disease is a major complication that causes morbidity and mortality in renal transplant recipients (RTRs) with hepatitis B virus (HBV) infection [1][2][3][4][5]. Many studies have reported HBV disease progression after renal transplantation [2,4,[6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

The role of HBV genotype core promoter and precore mutations in advanced liver disease in renal transplant recipients

Tsai

Chen

Lee

et al. 2009

Journal of Hepatology

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“…The use of immunosuppressive drugs enhances viral replication, leading to acceleration of liver injury and progression to hepatocellular failure (1). Moreover, HBV-associated GN may recur or develop de novo in the graft, reducing function or even ultimately inducing graft failure (2,3).…”

Section: Introductionmentioning

confidence: 99%

Impact of Pre-Existing Hepatitis B Infection on the Outcomes of Kidney Transplant Recipients in the United States

Reddy

Sampaio

Kuo

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Pre-existing hepatitis B virus (HBV) infection has been associated in inferior renal transplant outcomes. We examined outcomes of HBVϩ renal recipients in a more recent era with availability of oral anti-viral agents.Design, setting, participants, & measurements Using the Organ Procurement Transplant Network/United Network for Organ Sharing database, we selected adult primary kidney recipients transplanted in the United States (2001 to 2007). The cohort was divided into HBVϩ (surface antigen positive, n ϭ 1346) and HBVϪ patients (surface antigen negative; n ϭ 74,335). Five-year graft survival, patient survival, hepatic failure incidence, and associated adjusted risks were compared.Results HBVϩ recipients were more frequently Asian, had a lower body mass index, and glomerulonephritis was more prevalent as the etiology of ESRD. HBVϩ recipients had less pretransplant diabetes and cardiovascular disease, were less likely a living donor recipient, and were less likely to receive steroids at discharge. Five-year patient survival was 85.3% and 85.6% and graft survival was 74.9% and 75.1% for HBVϩ and HBVϪ, respectively. HBV infection was not a risk factor for death or kidney failure, although 5-year cumulative incidence of hepatic failure was higher in HBVϩ recipients (1.3% versus 0.2%; P Ͻ 0.001), and HBVϩ was associated with 5.5-and 5.2-fold increased risk for hepatic failure in living and deceased donors, respectively, compared with HBVϪ. ConclusionsIn a recent era (2001 to 2007), HBV-infected renal recipients were not at higher risk for kidney failure or death; however, they remain at higher risk of liver failure compared with HBVϪ recipients.

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“…The HCV core Ag test is an enzyme-linked immunosorbent assay (ELISA) that can be performed in routine diagnostic laboratories. Confirmation of HCV infection in dialysis population requires the detection of HCV viremia in anti-HCV-positive patients; also, assessment of HCV viral load is needed for monitoring the response to antiviral therapy (12). The purpose of the present study was to compare HCV core Ag quantification and PCR-based technology for measuring HCV viral load in the dialysis population.…”

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confidence: 99%

Novel Assay Using Total Hepatitis C Virus (HCV) Core Antigen quantification for Diagnosis of HCV Infection in Dialysis Patients

Fabrizi¹,

Lunghi

Aucella

et al. 2005

J Clin Microbiol

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Dialysis patients remain a high-risk group for hepatitis C virus (HCV) infection. The current diagnosis of HCV infection among dialysis patients includes serological assays and nucleic acid amplification technology (NAT) for assessing serum anti-HCV antibody and HCV viremia, respectively. However, current NAT techniques are expensive and labor-intensive and often lack standardization. An assay prototype designed to detect and quantify total HCV core antigen (total HCV core Ag) protein in serum and plasma in the presence or absence of anti-HCV antibodies has been recently developed. A comparison between a total anti-HCV core Ag enzyme-linked immunosorbent assay (ELISA) and a quantitative HCV RNA assay based on reverse transcription-PCR (RT-PCR) (Amplicor HCV Monitor test) was performed using a large (n ‫؍‬ 305) cohort of ELISA HCV 3.0 HCV-negative and -positive patients on maintenance dialysis. The concentrations of HCV core Ag and HCV RNA levels (measured by RT-PCR) were significantly correlated (r ‫؍‬ 0.471, P ‫؍‬ 0.0001) over a wide range of HCV RNA levels and were maintained among different HCV genotypes (HCV genotype 1, r ‫؍‬ 0.862, P ‫؍‬ 0.0001; HCV genotype 2, r ‫؍‬ 0.691, P ‫؍‬ 0.0001). We estimated that 1 pg of total HCV core Ag per ml is equivalent to approximately 19.952 IU of HCV RNA per ml, even if the wide range in the ratio of core Ag to HCV RNA (95% confidence intervals, 2.8 ؋ 10 3 to 1.6 ؋ 10 5 IU/ml) precluded definitive conclusions. In summary, total HCV core Ag proved to be useful for performing HCV RNA measurement among dialysis patients in routine laboratories without the need for special equipment or training. The present study supports the use of the total anti-HCV core Ag ELISA for assessing viral load among dialysis patients with HCV infection.Dialysis patients remain a high-risk group for hepatitis C virus (HCV) infection (11). The Centers for Disease Control and Prevention, Atlanta, Ga., have recently included semiannual anti-HCV testing for anti-HCV-negative patients in their infection control practices for hemodialysis units (6, 7).Routine diagnosis of HCV is based on detection of anti-HCV antibody. However, due to the absence of an efficient in vitro culture system for HCV or assays capable of detecting viral antigens, direct detection of HCV has depended on nucleic acid amplification technology (NAT) techniques. Indeed, serological assays for detecting anti-HCV antibody cannot distinguish between patients with active infection and those who have cleared the virus (29). NAT tests are based on nucleic acid amplification (PCR and transcription-mediated amplification) (16, 37) or signal amplification (branched-chain DNA assay) and are currently used to detect viremia (2, 36). Recently both assay systems have become semiautomated. Several problems still persist with these methods; PCR requires considerable skill and has limited reproducibility, while the branched-chain DNA assay requires a long incubation period. Both assays are also expensive. An assay prototype designed to detect and ...

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Hepatitis B Virus and Renal Transplantation

Cited by 29 publications

References 50 publications

The role of HBV genotype core promoter and precore mutations in advanced liver disease in renal transplant recipients

The role of HBV genotype core promoter and precore mutations in advanced liver disease in renal transplant recipients

Impact of Pre-Existing Hepatitis B Infection on the Outcomes of Kidney Transplant Recipients in the United States

Novel Assay Using Total Hepatitis C Virus (HCV) Core Antigen quantification for Diagnosis of HCV Infection in Dialysis Patients

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