Harmful long-term impact of hepatitis C virus infection in kidney transplant recipients

Background. The long-term impact of hepatitis C virus (HCV) infection in renal transplant recipients remains controversial, We report here our experience, in a homogeneous single center, of 499 patients with a fairly long follow-up, Methods, We retrospectively studied 499 hepatitis B virus-negative patients who received an initial cadaver donor kidney transplantation at Necker Hospital between January 1, 1979 and December 31, 1994, with a graft or patient survival of at least 6 months, Anti-HCV antibodies were detected at time of transplantation in 112 patients (22%), Patient survival and causes of death were compared among anti-HCV-positive and -negative patients Results, Our results clearly indicate that first cadaver kidney transplant recipients with anti-HCV antibodies had a significantly shorter patient and graft long-term survival than recipients without anti-HCV antibodies (P<0.01 and P<0.0001 respectively), Mean follow-up time after transplantation was 79+/-2 months in the former group and 81+/-5 months in the latter (NS), Increased mortality was primarily caused by liver disease (P<0.001) and sepsis (P<0.01). In a multivariate analysis, HCV infection significantly affected the mortality rate (odds ratio: 2.8), Conclusions, These results suggest that HCV infection has a harmful long-term impact on the survival of kidney transplant recipients.