Management of Hepatitis C Infection in Renal Transplant Recipients

Natov, S; Pereira, Brian J.G.

doi:10.1034/j.1600-6143.2002.20601.x

Cited by 14 publications

(10 citation statements)

References 61 publications

(64 reference statements)

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“…Although few ALT measurements were available on our study patients, we observed the reported trend of normal or near normal ALT values in most EIA positive and negative patients infected with HCV (Chan et al, 1993;Natov and Pereira, 2002;Pol et al, 1995;Saab et al, 2001a,b). This trend supported our impression that ALT measurements are inadequate for monitoring acquisition of HCV infection in this population.…”

Section: Discussionsupporting

confidence: 59%

“…HCV-infected HD patients may test negative for HCV antibodies either because of early stage of infection or because their compromised immune system is unable to mount an antibody response (Almroth et al, 2002;Hanuka et al, 2002). Serum alanine aminotransferase (ALT) levels are also not a reliable indication of HCV infection, since HD patients often exhibit subnormal, normal or only slightly elevated ALT levels (Fabrizi et al, 2002;Natov and Pereira, 2002;Pol et al, 1993;Saab et al, 2001a,b). Even a newly elevated ALT does not predict infection and has been shown to be specific, but not sensitive for chronic HCV infection in this population (Saab et al, 2001a,b).…”

Section: Introductionmentioning

confidence: 96%

See 1 more Smart Citation

Improved detection of HCV Infection in hemodialysis patients using a new HCV RNA qualitative assay: experience of a transplant center

Khan¹,

Aswad²,

Shidban³

et al. 2004

Journal of Clinical Virology

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 96%

Improved detection of HCV Infection in hemodialysis patients using a new HCV RNA qualitative assay: experience of a transplant center

Khan¹,

Aswad²,

Shidban³

et al. 2004

Journal of Clinical Virology

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“…Furthermore, not all donor kidneys positive for hepatitis C antibody are infective. This is relevant because Pereira et al (38) and Natov et al (39) also reported that only donors with HCV antigen in the peripheral blood circulation are likely to transmit HCV to the kidney. Fortunately, hepatitis C infection before seroconversion in potential donors (specifically, blood donors) is rare (40).…”

Section: Discussionmentioning

confidence: 95%

Donor Hepatitis C Seropositivity

Bucci¹,

Matsumoto²,

Swanson³

et al. 2002

Journal of the American Society of Nephrology

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“…Most reviews of the kidney transplant literature agree that posttransplantation HCV is more morbid than HCV acquired before transplantation. It has been assumed this is due to the difficulty of treatment for HCV infection after kidney transplantation as a result of the increased risk of allograft rejection associated with interferon therapy (25,26). Therefore, treatment of HCVϩ recipients is strongly recommended before transplantation (27,28).…”

Section: Discussionmentioning

confidence: 99%

Impact of Diabetes and Hepatitis after Kidney Transplantation on Patients Who Are Affected by Hepatitis C Virus

Abbott

Lentine

Bucci

et al. 2004

Journal of the American Society of Nephrology

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Abstract. Complications associated with use of donor hepatitis C-positive kidneys (DHCVϩ) have been attributed primarily to posttransplantation liver disease (as a result of hepatitis C disease). The role of posttransplantation diabetes has not been explored in this setting. With the use of the United States Renal Data System database, 28,942 Medicare KT recipients were studied from January 1, 1996, through July 31, 2000. Cox proportional hazards regression models were used to calculate adjusted hazard ratios (AHR) for the association of sero-pairs for HCV (Dϩ/RϪ, Dϩ/Rϩ, DϪ/Rϩ and DϪ/RϪ) with Medicare claims for de novo posttransplantation HCV and posttransplantation diabetes. The peak risk for posttransplantation HCV was in the first 6 mo after transplantation. The incidence of posttransplantation HCV after transplantation was 9.1% in Dϩ/RϪ, 6.3% in Dϩ/Rϩ, 2.4% in DϪ/Rϩ, and 0.2% in DϪ/RϪ. The incidence of posttransplantation diabetes after transplantation also peaked early and was 43.8% in Dϩ/RϪ, 46.6% in Dϩ/Rϩ, 32.3% in DϪ/Rϩ, and 25.4% in DϪ/RϪ. Associations for both complications were significant in adjusted analysis (Cox regression). Both posttransplantation HCV (AHR, 3.36; 95% confidence interval, 2.44 to 4.61) and posttransplantation diabetes (AHR, 1.81; 95% confidence interval, 1.54 to 2.11) were independently associated with an increased risk of death, but posttransplantation diabetes accounted for more years of life lost, particularly among recipients of DHCVϩ kidneys. Posttransplantation diabetes may contribute substantially to the increased risk of death associated with use of DHCVϩ kidneys and accounts for more years of life lost than posttransplantation HCV. Because HCV infection acquired after transplantation is so difficult to treat, methods that have been shown to reduce viral transmission warrant renewed attention.

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Management of Hepatitis C Infection in Renal Transplant Recipients

Cited by 14 publications

References 61 publications

Improved detection of HCV Infection in hemodialysis patients using a new HCV RNA qualitative assay: experience of a transplant center

Improved detection of HCV Infection in hemodialysis patients using a new HCV RNA qualitative assay: experience of a transplant center

Donor Hepatitis C Seropositivity

Impact of Diabetes and Hepatitis after Kidney Transplantation on Patients Who Are Affected by Hepatitis C Virus

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