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Hepatitis C Has Negative Effect on Long-Term Outcome in Renal Allograft Recipients: Presented at ERA-EDTA

By Lynda Jackson

COPENHAGEN, DENMARK -- July 18, 2002 -- Ten-year graft survival in hepatitis C virus seropositive renal allograft recipients was significantly lower than that of hepatitis C virus seronegative recipients evaluated in a recent study.

Polish researchers reported the findings here July 17 at the 39^th annual Congress of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA).

Dr. Magdalena Durlik, of the Transplant Institute, Warsaw Medical School, Warsaw, Poland, said the effect of hepatitis B virus (HBV) infection and hepatitis C virus (HCV) infection on renal transplant outcome remains controversial. She explained that the aim of the study was to evaluate HBV and HCV infections as predictors of graft loss in renal allograft recipients.

The study enrolled 140 women and 191 men, mean age 38 years, who received kidney allografts between 1991 and 1993. Maintenance therapy was prednisone, cyclosporin, and azathoiprine, and patients were followed for up to 10 years.

At the time of transplantation, 73 patients (22 percent) were positive for HBs antigen and 177 (53 percent) were positive for HCV antibodies. The study end point was graft loss, defined as requiring dialysis. Kaplan-Meier estimation and proportional hazard analysis were used for the evaluation of the incidence of graft loss.

Dr. Durlik said the risk of graft loss was significantly higher in HCV-infected patients (44 percent, p<0.5), than in Hepatitis B infected patients (nine percent, p>0.7). Ten-year graft survival was significantly lower in HCV-positive patients (53 percent) compared with HCV-negative patients (64 percent, p<0.5).

No significant difference in graft survival was seen between HBV-positive and - HBV-negative patients.

The relative risk of graft loss was significantly higher in HCV-positive patients. Ten-year graft survival was 63 percent in noninfected patients, 68 percent in HBV-positive patient, 54 percent in HCV-positive patients, and 48 percent in patients co-infected with HCV and HBV.

The total 10-year graft survival in all patients was 60 percent.

Dr. Durlik concluded that HCV infection has a deleterious effect on long-term outcome in renal dialysis patients.

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