Hepatitis C and renal transplantation: a review on historical aspects and current issues

Moghaddam, Seyed Mohammadmehdi Hosseini; Alavian, Seyed Moayed; Kermani, N. Arjmand

doi:10.1002/rmv.590

Cited by 12 publications

(8 citation statements)

References 143 publications

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“…In a previous survey in Iran, HCV RNA was detected in 6.4% of liver transplant recipients (26). Moreover, the infection in renal transplant recipients varies between 2.6% and 66% in different geographical areas of the world (27)(28)(29).…”

Section: Discussionmentioning

confidence: 95%

Hepatitis C Virus Load in Seropositive Liver and Kidney Transplant Recipients by Quantitative Real-Time PCR Before and After Transplantation

Behzadi

Ziyaeyan

2013

Jundishapur J Microbiol

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Background: Hepatitis C virus (HCV) infection is one the major health concern among the infected transplant patients. Considering several complications of the disease in them, pre and post-transplantation studies should be performed for monitoring of the infection, as well as, developing new treatment protocols. Objectives: The current study was conducted to determine the Hepatitis C Virus RNA level among seropositive liver and kidney transplant recipients in Namazi Hospital; the main transplantation center in southern Iran. Materials and Methods: RNAs were extracted from 105 serum samples of seropositive liver and kidney transplant recipients and analyzed by Real-time PCR assay using a set of primers. Results: HCV RNA was detected in a total of 46/105 (43.8%) recipients' serum samples [39/46 (84.8%) males and 7/46 (15.2%) females]. Moreover, 8/46 (17.4%) and 38/46 (82.6%) were kidney and liver recipients, respectively. The copy number of HCV RNA, measured by the Real-time PCR assay, ranged from 5 × 102 to 3.14 × 109 copies/mL; Median 2.37 × 105 copies/mL and 1.7 × 103 to 9.44 × 104 copies/mL; Median 2.89 × 104 copies/ mL in liver and renal transplant patients, respectively. The comparison of viral load between liver pre transplant recipients group and post transplant counterpart indicated that the copy number of HCV RNA was significantly higher in the post transplant recipients (P = 0.033). The prevalence of the viral nucleic acid was significantly higher in males than in females (P = 0.026). Similarly, with regards to the age groups, the prevalence of HCV RNA was significantly higher in age group ≥ 45 years than age group < 45 years (P = 0.028). Conclusions: Considering the results, it can be concluded that HCV RNA detection is strongly suggested in transplant patients group to determine the prevalence of the disease and their responses to antiviral therapy and diagnosis of drug resistance. In addition, continuous and regular surveillance of HCV RNA level in such patients is highly recommended in order to better manage the complications of graft loss and reduce the mortality rate. Further studies are needed to find new therapeutic methods to lower the incidence of infection of new healthy allograft tissues in HCV RNA positive recipients.

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Section: Discussionmentioning

confidence: 95%

Hepatitis C Virus Load in Seropositive Liver and Kidney Transplant Recipients by Quantitative Real-Time PCR Before and After Transplantation

Behzadi

Ziyaeyan

2013

Jundishapur J Microbiol

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“…In a meta-analysis, Fabrizi et al identified 24 clinical trials with 529 unique patients, where a summary estimate of SVR was 39% (95% CI 32-46) and a drop-out rate of 19% (95% CI [13][14][15][16][17][18][19][20][21][22][23][24][25][26] [80••]. The main reasons for discontinuation of therapy were flu like symptoms, gastro-intestinal and hematological adverse effects.…”

Section: Interferon Monotherapymentioning

confidence: 99%

“…The prevalence of anti-HCV antibodies among kidney recipients ranges from 2.6% to 66% dependant on country of origin and transplant center [13]. Most renal transplant recipients have acquired HCV infection prior to transplantation [14].…”

Section: Renal Transplant Patientsmentioning

confidence: 99%

Management of Hepatitis C in Patients with Chronic Kidney Disease

Al-Freah

Zeino

Heneghan

2011

Curr Gastroenterol Rep

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Chronic kidney disease represents a global health problem. Chronic hepatitis C virus (HCV) infection is prevalent in patients with end stage renal disease (ESRD) on hemodialysis (HD) and in renal transplant recipients with significant impact on morbidity and mortality. Furthermore, HCV can cause various forms of glomerulopathy with the predominant type being cryglobulinemia associated membranoproliferative glomerulonephritis. Liver enzymes are traditionally used as markers of liver injury; however, there is wide variation in aminotransferase levels in patients with ESRD. Therefore, diagnosis of chronic hepatitis C (CHC) in patients with ESRD is based on HCV antibody testing and further confirmation with polymerase chain reaction testing. Current standard therapy for CHC is composed of pegylated interferon and ribavirin. However, this combination is challenging in patients with ESRD due to its tolerability. We describe in this review relevant issues in epidemiology, diagnosis and management of CHC in ESRD, HD and renal transplant recipients.

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“…1,2 The diversity of these rates results from differences between centers, countries, and geographic areas. 3 The prevalence of HCV infection is higher in renal transplant recipients (11% to 49%) than the hemodialysis population. 4,5 There is controversy regarding the long-term outcomes following kidney transplant between patients who have or do not have HCV.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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Objectives: Studies have demonstrated worse graft and patient survival among hepatitis C viruspositive patients following kidney transplant. Eradication of hepatitis C virus infection before renal transplant with interferon should be considered in hepatitis C virus-infected patients undergoing dialysis who are on the waiting list for transplant. We investigated whether pretransplant hepatitis C virus infection treatment affected graft and patient survival, and we evaluated other contributing factors to these outcomes. There were 14 of 28 patients (50%) who achieved sustained virologic response, and only 1 patient had relapse. Graft survival was significantly lower in patients who had treatment (6 y vs 9 y; P ≤ .003). However, patient survival rates were similar between groups. Patients who had interferon were younger and had longer hemodialysis duration before renal transplant than patients without treatment. Higher viral load was associated with higher mortality which was caused by sepsis. Conclusions: Pretransplant hepatitis C virus infection treatment, although recommended before renal transplant, does not always have good outcomes. Pretransplant dialysis treatment period, age of recipient, and posttransplant higher viral replication rates may be important contributing factors related to graft and patient survival.

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Hepatitis C and renal transplantation: a review on historical aspects and current issues

Cited by 12 publications

References 143 publications

Hepatitis C Virus Load in Seropositive Liver and Kidney Transplant Recipients by Quantitative Real-Time PCR Before and After Transplantation

Hepatitis C Virus Load in Seropositive Liver and Kidney Transplant Recipients by Quantitative Real-Time PCR Before and After Transplantation

Management of Hepatitis C in Patients with Chronic Kidney Disease

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