Histological evolution of hepatitis C virus infection after renal transplantation

• Published in: Clinical transplantation Vol. 26; no. 6; pp. 842 - 848
• Main Authors: de Oliveira Uehara, Silvia Naomi, Emori, Christini Takemi, Pereira, Patrícia da Silva Fucuta, Perez, Renata M., Pestana, José Osmar Medina, Lanzoni, Valéria Pereira, Silva, Ivonete Sandra Souza e, Silva, Antonio Eduardo Benedito, Ferraz, Maria Lucia Cardoso Gomes
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Blackwell Publishing Ltd 01-11-2012; Wiley
• Subjects: Adult; Age; Alanine transaminase; Aspartate aminotransferase; Biological and medical sciences; Biopsy; chronic kidney failure; Disease Progression; Evolution; Female; Fibrosis; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Glomerular Filtration Rate; hemodialysis; Hepacivirus - pathogenicity; Hepatitis C; Hepatitis C virus; Hepatitis C, Chronic - etiology; Hepatitis C, Chronic - pathology; Hepatitis C, Chronic - virology; Human viral diseases; Humans; Infection; Infectious diseases; Interferon; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - surgery; Kidney transplantation; Kidney Transplantation - adverse effects; Liver; Liver Cirrhosis - etiology; Liver Cirrhosis - pathology; Liver Cirrhosis - virology; liver disease; Longitudinal Studies; Male; Medical sciences; Postoperative Complications; Prognosis; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Survival Rate; Tissue, organ and graft immunology; Viral diseases; Viral hepatitis; Kidney disease; Urinary system disease; Chronic renal failure; liver disease; Hemodialysis; hepatitis C; Hepatic disease; Histology; Homotransplantation; chronic kidney failure; Kidney; Infection; Medicine; Extrarenal dialysis; Treatment; Urinary system; Surgery; Viral disease; Digestive diseases; Evolution; Graft; Viral hepatitis C; Kidney transplantation
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2012.01635.x

Background
information regarding histological progression of hepatitis C after renal transplant (RTx) is scarce.
Aims
To analyze clinical and laboratory evolution and histological progression of hepatitis C in patients evaluated before and after RTx.
Methods
Twenty‐two HCV‐infected patients submitted to liver biopsy pre‐ and post‐RTx were included. A semiquantitative analysis of necroinflammatory activity and fibrosis staging was performed and the two biopsies were compared.
Results
Patients were mostly men (73%) with mean age of 36 ± 9 yr. Time post‐transplant was 4 ± 2 yr and time between biopsies was 5 ± 2 yr. An elevation of alanine aminotransferase (p = 0.041) and aspartate aminotransferase (p = 0.004) levels was observed in the post‐transplant period. Fibrosis progression after renal transplantation was observed in 11 (50%) of the patients, and necroinflammatory activity worsening was observed in 7 (32%) of the patients. The histological progression occurred even among those without significant histological lesions in pre‐transplant biopsy.
Conclusion
The findings of this study suggest that the practice of indicating treatment in the pre‐transplant phase based mainly on histological disease should be revised, because a high proportion of patients present disease progression. Because interferon cannot be used safely after RTx, treatment should be indicated for all ESRD patients with hepatitis C.