Hepatitis C virus infection in renal transplant patients: a comparative study with immunocompetent patients

Hepatitis C virus infection in renal transplant patients: a comparative study with immunocompetent patients

Author Perez, R. M. Google Scholar
Ferreira, ASP Google Scholar
Souza e Silva, Ivonete Sandra de Autor UNIFESP Google Scholar
Medina-Pestana, J. O. Google Scholar
Lanzoni, V. P. Google Scholar
Silva, AEB Google Scholar
Ferraz, MLG Google Scholar
Institution Universidade Federal do Rio de Janeiro (UFRJ)
Universidade Federal de São Paulo (UNIFESP)
Abstract The behavior of hepatitis C in states of immunodeficiency is poorly understood and it is still unclear whether the characteristics of hepatitis C virus (HCV) infection in renal transplant patients differ from those observed in immunocompetent subjects. the aim of this study was to compare the biochemical and histologic characteristics of chronic HCV infection between renal transplant and immunocompetent patients. Forty-one HCV-RNA-positive renal transplant patients and 41 immunocompetent controls matched for gender, age at infection and time of infection were included in the study. the groups were compared regarding laboratory and histologic variables. Renal transplant patients showed lower alanine aminotransferase (ALT) levels (p = 0.005) and higher levels of gamma-glutamyltransferase (p = 0.003), alkaline phosphatase (p < 0.001), and direct bilirubin (p < 0.001) when compared with controls. Histologic analysis revealed less intense portal (p < 0.001) and periportal (p = 0.046) inflammatory infiltrate in renal transplant patients but a larger proportion of cases with confluent necrosis (p = 0.043). No difference in the presence of septal fibrosis, hepatic steatosis, bile duct injury and siderosis was observed. However, there was a difference in the presence of lymphoid aggregates, which were less frequent in the renal transplant group (p < 0.001). in conclusion, the characteristics of hepatitis C in renal transplant patients differ from that observed in immunocompetent patients. in renal transplant patients, HCV infection is biochemically characterized by lower ALT levels and higher frequency of cholestasis. Regarding histology, despite lower frequency of lymphoid aggregates and less intense portal/periportal inflammatory infiltrate, a greater lobular damage was observed. the impact of these differences on the progression of fibrosis remains to be established.
Keywords alanine aminotransferase
hepatitis C
kidney transplantation
liver biopsy
Language English
Date 2005-12-01
Published in Clinical Transplantation. Oxford: Blackwell Publishing, v. 19, n. 6, p. 763-768, 2005.
ISSN 0902-0063 (Sherpa/Romeo, impact factor)
Publisher Blackwell Publishing
Extent 763-768
Origin http://dx.doi.org/10.1111/j.1399-0012.2005.00418.x
Access rights Closed access
Type Article
Web of Science ID WOS:000233204800010
URI http://repositorio.unifesp.br/handle/11600/28591

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