Histological evolution of hepatitis C virus infection after renal transplantation

Authors


  • Conflict of interest: The authors declare that they do not have any conflict of interest. This study has been supported by the Brazilian National Council for Scientific and Technological Development (CNPq).

Corresponding author: Silvia Naomi de Oliveira Uehara, Rua 9 de julho, 1408 – Vila Ipiranga – Campo Grande, Mato Grosso do Sul - CEP: 79081-050, Brazil.

Tel.: 55 67 9994 3637; fax: 55 67 3345 3651

e-mail: siuehara@gmail.com

Abstract

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.

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