Factors associated with the intensity of liver fibrosis in renal transplant patients with hepatitis B virus infection

Factors associated with the intensity of liver fibrosis in renal transplant patients with hepatitis B virus infection

Author Matos, Carla Adriana Loureiro de Autor UNIFESP Google Scholar
Perez, Renata de Mello Autor UNIFESP Google Scholar
Lemos, Lara Barros Autor UNIFESP Google Scholar
Pestana, Jose Osmar Medina Autor UNIFESP Google Scholar
Lanzoni, Valeria Pereira Autor UNIFESP Google Scholar
Albertoe, Fernando L. Google Scholar
Moreira, Eloisa S. Google Scholar
Silva, Antonio Eduardo Benedito Autor UNIFESP Google Scholar
Ferraz, Maria Lucia Cardoso Gomes Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Fleury Med Diagnost Ctr
Abstract Background Hepatitis B may show a more aggressive course after kidney transplantation, but the factors associated with the progression of fibrosis in this group have not been identified.Objectives To determine the influence of hepatitis B virus (HBV) viral load and host-related factors on the progression of hepatic fibrosis in hepatitis B virus-infected renal transplant recipients.Patients and methods Renal transplant patients positive for HBV surface antigen (HBsAg) and submitted to a liver biopsy because of evidence of viral replication were included. Patients with advanced fibrosis (METAVIR F3-F4) were compared with patients with mild fibrosis (F0-F2) regarding sex, age, estimated time since infection, post-transplant time, donor type, history of renal transplantation, alanine aminotransferase, anti-hepatitis C virus, HBeAg and quantitative hepatitis B virus-DNA. Logistic regression analysis was applied to identify variables independently associated with more advanced fibrosis.Results Fifty-five patients (75% men, 41 +/- 11 years) with a mean post-transplant time of 5 +/- 4 years were included. HBeAg was detected in 67% of the patients and anti-hepatitis C virus in 35%. The median hepatitis B virus-DNA level was 2.8 x 10(8) copies/ml. Seventeen (31%) patients had advanced fibrosis. Using logistic regression analysis, the only variable that showed an independent association with more advanced stages of fibrosis was post-transplant time (P=0.03, odds ratio: 1.2, 95% confidence interval: 1.02-1.45).Conclusion Hepatitis B virus viral load, although very high, and hepatitis B virus/hepatitis C virus coinfection are not related to the intensity of liver fibrosis in renal transplant patients infected with hepatitis B virus. Post-transplant time was the only factor independently associated with more advanced liver fibrosis, suggesting the influence of immunosuppression on the progression of liver disease in these patients.
Keywords fibrosis
hepatitis B
hepatitis B virus-DNA
hepatitis C
kidney transplantation
liver biopsy
Language English
Date 2007-08-01
Published in European Journal Of Gastroenterology & Hepatology. Philadelphia: Lippincott Williams & Wilkins, v. 19, n. 8, p. 653-657, 2007.
ISSN 0954-691X (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 653-657
Origin https://doi.org/10.1097/MEG.0b013e328133f091
Access rights Closed access
Type Article
Web of Science ID WOS:000254356100007
URI http://repositorio.unifesp.br/11600/43588

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