Hepatitis C Infection, Time in Renal-Replacement Therapy, and Outcome after Kidney Transplantation

Bruchfeld, Annette; Wilczek, H; Elinder, Carl‐Gustaf

doi:10.1097/01.tp.0000131948.29742.24

Cited by 125 publications

(88 citation statements)

References 30 publications

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“…Despite a survival advantage over dialysis, reports of outcomes among kidney transplant recipients with HCVþ compared to those without hepatitis C virus (HCVÀ) are often conflicting. Whereas many studies have shown a detrimental effect of HCVþ on kidney transplant graft survival relative to HCVÀ recipients, others have not found a difference (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Interpretation of many of these reports is limited by various methodological issues.…”

Section: Introductionmentioning

confidence: 99%

Effect of HCV, HIV and Coinfection in Kidney Transplant Recipients: Mate Kidney Analyses

Xia

Friedmann

Yaffe

et al. 2014

American Journal of Transplantation

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Reports of kidney transplantation (KTX) in recipients with hepatitis C virus (HCVþ), human immunodeficiency virus (HIVþ) or coinfection often do not provide adequate adjustment for donor risk factors. We evaluated paired deceased-donor kidneys (derived from the same donor transplanted to different recipients) in which one kidney was transplanted into a patient with viral infection (HCVþ, n ¼ 1700; HIVþ, n ¼ 243) and the other transplanted into a recipient without infection (HCVÀ n ¼ 1700; HIVÀ n ¼ 243) using Scientific Registry of Transplant Recipients data between 2000 and 2013. On multivariable analysis (adjusted for recipient risk factors), HCVþ conferred increased risks of death-censored graft survival (DCGS) (adjusted hazard ratio [aHR] 1.24, 95% confidence interval [CI] 1.04-1.47) and patient survival (aHR 1.24, 95% CI 1.06-1.45) compared with HCVÀ. HIVþ conferred similar DCGS (aHR 0.85, 95% CI 0.48-1.51) and patient survival (aHR 0.80, 95% CI 0.39-1.64) compared with HIVÀ. HCV coinfection was a significant independent risk factor for DCGS (aHR 2.33; 95% CI 1.06, 5.12) and patient survival (aHR 2.88; 95% CI 1. 35, 6.12). On multivariable analysis, 1-year acute rejection was not associated with HCVþ, HIVþ or coinfection. Whereas KTX in HIVþ recipients were associated with similar outcomes relative to noninfected recipients, HCV monoinfection and, to a greater extent, coinfection were associated with poor patient and graft survival.

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Section: Introductionmentioning

confidence: 99%

Effect of HCV, HIV and Coinfection in Kidney Transplant Recipients: Mate Kidney Analyses

Xia

Friedmann

Yaffe

et al. 2014

American Journal of Transplantation

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“…[2][3][4] Recently, several clinical trials provided with long follow-up, large size, and appropriate statistical approach have demonstrated the negative impact of HCV on patients (Table 1) and graft survival (Table 2) after RT. [5][6][7][8][9][10][11][12][13][14] A recent meta-analysis of clinical and observational surveys found that RT recipients with anti-HCV antibody have an increased risk of mortality and graft failure compared with anti-HCV antibody negative patients.…”

Section: Introductionmentioning

confidence: 99%

Review article: hepatitis C virus and calcineurin inhibition after renal transplantation

Fabrizi

Bromberg

Elli

et al. 2005

Aliment Pharmacol Ther

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SUMMARYThe impact of hepatitis C virus on patient and graft survival after renal transplantation remains controversial. However, recent studies have given emphasis on the detrimental role of hepatitis C on long-term patient and graft survival after renal transplantation. Various mechanisms can promote the lower survival in hepatitis C virus-positive recipients, i.e. post-transplant diabetes mellitus, liver disease and infections.Novel evidence has been accumulated showing the inhibitory activity of ciclosporin on the hepatitis C virus replication rate in human hepatocytes; ciclosporin has been shown in vitro to suppress hepatitis C virus replication as effectively as interferon alpha. This effect has not been seen with tacrolimus and is separate from its immunosuppressive activity. Data from patients with normal kidney function or after bone marrow transplantation show that ciclosporin inhibits hepatitis C virus replication. It appears that the progression of liver fibrosis is slower in hepatitis C virus-positive liver transplant recipients treated with ciclosporin than tacrolimus. In contrast, the clinical outcome of hepatitis C in hepatitis C virus-positive patients after liver transplantation treated with ciclosporin vs. tacrolimus has given mixed results. No information after renal transplantation is available.Various parameters can promote the worsening of hepatitis C after renal transplantation but choice of calcineurin inhibition is one of the few risk factors that can potentially be modified by the physician. Prospective, comparative trials of ciclosporin and tacrolimus with large size and adequate follow-up after renal transplantation are in progress.

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“…This is thought to be because of the immune protection provided by the liver graft (72,73). HCV-infected kidney transplant recipients were reported to have higher post-transplant mortality and lower renal graft survival (74). HCV treatment is recommended by KDIGO (Kidney Disease: Improving Global Outcomes) for patients who are candidates for kidney transplantation if comorbidities permit (75).…”

Section: Renal Failure and Hcv Treatment During The Transplant Periodmentioning

confidence: 99%

New modalities in the treatment of HCV in pre and post - transplantation setting

Araz

Durand²,

Gürakar³

2015

Turk J Gastroenterol

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End-stage liver disease and hepatocellular carcinoma (HCC) secondary to hepatitis C virus (HCV) infection are the leading indications for liver transplantation (LT) in developed countries. Recurrence of HCV following LT is universal if the recipient has detectable serum HCV RNA at the time of LT. Recurrent HCV has an accelerated course and is associated with poor long term patient and graft survival. Interferon (IFN)-based regimens have achieved low Sustained Virological Rates (SVR) in this setting and are associated with a high rate of adverse events, resulting in treatment discontinuation. With advances in understanding the HCV life cycle, drugs targeting specific steps, particularly inhibiting the NS3/4A protease, NS5B RNA dependent RNA polymerase and the NS5A protein, have been developed. Sofosbuvir (SOF), a nucleotide analogue inhibitor of NS5B polymerase was the first compound to enter the market. Combinations of SOF with new HCV antivirals from other classes have allowed for IFN-free regimens with low rates of adverse events and SVR rates >90%. With the availability of newer agents, the approach to the treatment of HCV infection during the pre-and post-liver transplantation period has changed. We will hereby review the current status of HCV treatment and discuss the potential future therapies in the transplant setting.

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Hepatitis C Infection, Time in Renal-Replacement Therapy, and Outcome after Kidney Transplantation

Cited by 125 publications

References 30 publications

Effect of HCV, HIV and Coinfection in Kidney Transplant Recipients: Mate Kidney Analyses

Effect of HCV, HIV and Coinfection in Kidney Transplant Recipients: Mate Kidney Analyses

Review article: hepatitis C virus and calcineurin inhibition after renal transplantation

New modalities in the treatment of HCV in pre and post - transplantation setting

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