Hepatitis C Virus Seropositivity at the Time of Renal Transplantation in the United States: Associated Factors and Patient Survival


  • The opinions are solely those of the authors and do not represent an endorsement by the Department of Defense.


National statistics for patient characteristics and survival of renal transplant recipients positive for hepatitis C virus (HCV+) at the time of renal transplant are presented.

A historical cohort analysis of 33 479 renal transplant recipients in the United States Renal Data System from 1 July, 1994 to 30 June, 1997 has been carried out. The medical evidence form was also used for additional variables, but because of fewer available values, this was analyzed in a separate model. Outcomes were patient characteristics and survival associated with HCV+.

Of 28 692 recipients with valid HCV serologies, 1624 were HCV+ at transplant (5.7% prevalence). In logistic regression analysis, HCV+ was associated with African-American race, male gender, cadaveric donor type, increased duration of pre-transplant dialysis, previous transplant, donor HCV+, recipient (but not donor) age, serum albumin, alcohol use, and increased all-cause hospitalizations. Diabetes and IgA nephropathy were less associated with HCV+. Total all-cause, unadjusted mortality was 13.1% in HCV+ vs. 8.5% in HCV– patients (p < 0.01 by log rank test). In Cox regression, mortality was higher for HCV+ (adjusted hazard ratio = 1.23, 95% confidence interval = 1.01–1.49, p = 0.04).

HCV+ recipients were more likely to be African-American, male, older, and to have received repeat transplants and donor HCV+ transplants. HCV+ recipients also had substantially longer waiting times for transplant. In contrast to recent studies, diabetes did not have an increased association with HCV+ , perhaps due to limitations of the database. HCV+ recipients had increased mortality and hospitalization rates compared with other transplant recipients.