Premium
Histological evolution of hepatitis C virus infection after renal transplantation
Author(s) -
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
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2012.01635.x
Subject(s) - medicine , transplantation , virology , virus , immunology , kidney transplantation , renal transplant
Background information regarding histological progression of hepatitis C after renal transplant ( RT x) is scarce. Aims To analyze clinical and laboratory evolution and histological progression of hepatitis C in patients evaluated before and after RT x. Methods Twenty‐two HCV ‐infected patients submitted to liver biopsy pre‐ and post‐ RT x 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 RT x, treatment should be indicated for all ESRD patients with hepatitis C .