Outcome of HCV infection after renal transplantation

Abstract

The fate and significance of hepatitis C virus (HCV) infection after renal transplantation (TP) remain debated. We therefore evaluated the incidence and outcome of HCV infection in 120 kidney graft recipients both at the time of TP and 54 +/- 28 (13 to 123) months later using ELISA-II and RIBA-II immunoblot. Furthermore, the presence of anti-HCV antibodies at follow-up was correlated with HCV viremia, as detected by the nested polymerase chain reaction (PCR), and with chronically abnormal ALT levels. At the time of TP, 17 patients (14.2%) had anti-HCV antibodies. Compared to anti-HCV (-) patients, anti-HCV (+) patients had a longer duration of pre-TP dialysis (P < 0.001) and had received more pre-TP blood transfusions (P < 0.01). After an average follow-up of 48.5 +/- 24.7 (21 to 97) months, all these patients remained anti-HCV (+) but only 10 were still RIBA "reactive" due to the loss of reactivity against the 5-1-1, C100 and C33 (but not the C22) antigens. Five initially anti-HCV (-) patients had become (+) at follow-up. Among the 22 patients anti-HCV (+) at follow-up, 20 had HCV-RNA detectable by PCR but only 10 had elevated ALT. Ten out of 13 HBsAg (-) patients with elevated ALT were anti-HCV (+). Our study indicates that disappearance of ELISA-II anti-HCV antibodies is rare in kidney recipients and that HCV infection may also occur after TP. Anti-HCV antibodies are likely to reflect a persisting infection as suggested by the frequent detection of HCV-RNA.(ABSTRACT TRUNCATED AT 250 WORDS)

Lymphocyte T helper‐specific reactivity in sustained responders to interferon and ribavirin with negativation (seroreversion) of anti‐hepatitis C virus

“…Absence of anti‐HCV virus antibodies has been also detected in renal failure patients in haemodialysis (23) and after renal transplantation (24). In a study done in Israel, the loss of anti‐HCV was associated with a low viral load HCV RNA by PCR (25).…”

Universal precautions prevent hepatitis C virus transmission: A 54 month follow-up of the Belgian multicenter study

“…ELISA 2 positive patients were tested by the second-generation recombinant immunoblot assay (RIBA 2; Ortho). ELISA 3 positive patients were tested by the third generation RIBA [15] and/or the reverse transcriptase nested polymerase chain-reaction (RT-PCR) for the detection of HCV-RNA [17]. The detection of antibodies against at least one HCV antigen or of HCV-RNA was considered as confirmatory.…”

Infection rate and spontaneous seroreversion of anti-hepatitis C virus during the natural course of hepatitis C virus infection in the general population

“…6 Spontaneous clearance of the virus occurs in an estimated 10-25% of infected individuals after acute infection 6 yet controversy exists regarding the existence and frequency of spontaneous antibody clearance during the natural course of chronic HCV infection (that is, seroreversion). Although this phenomenon has been reported in those undergoing haemodialysis, 7 in immunosuppressed patients, 8 and in immunocompetent individuals receiving interferon (IFN) therapy, 9 its occurrence in the immunocompetent general population and the correlation with clearance of HCV viraemia have not been sufficiently documented.…”