Recent research demonstrates that hepatitis C virus infection is a bad prognostic indicator for patient and graft survival duration in renal transplant recipients.
Hepatitis C virus (HCV) infection is reported in 3%-64% of renal allograft recipients; the prevalence depends on the geographic area. Infections are the commonest cause of death in renal transplant recipients.
Researchers from the Armed Forces Medical College, Pune, and Army Hospital Research and Referral, Delhi Cantt, assessed the effect of HCV infection on graft and patient survival in renal allograft recipients.
The researchers analyzed medical records of renal allograft recipients who were transplanted between June 1990 and March 2004. Patients were divided into those positive and negative for anti-HCV antibody. Graft and patient survival were compared between the groups.
It was found that of 126 patients studied, 35 were positive for anti-HCV antibody. In 7 patients, the antibodies were detected for the first time after renal transplant. Mean patient and graft survival duration in the anti-HCV negative group was longer than in the anti-HCV positive group. 22 patients died - 8 (22.8%) in the anti-HCV positive group and 14 (15.3%) in the negative group. In the anti-HCV positive group, infections were the cause of death in 5 patients and 3 patients died of liver cell failure. In the anti-HCV negative group, corresponding figures were 13 and one.
The authors, writing in the July-August issue of Indian Journal of Gastroenterology, conclude that HCV-positive compared with HCV-negative renal transplant patients have lower recipient and graft survival duration. There may be a case for attempting to clear the viremia in the pre-transplant period.