HBV, HCV Control Aids Kidney Transplant Outcomes
Patients with viral suppression have outcomes similar to those of noninfected patients
MONDAY, March 25, 2019 (Pharmacist's Briefing) -- The outcomes of kidney transplants in patients with viral suppression are as good as those for kidney transplants in patients not infected with hepatitis B virus (HBV) or hepatitis C virus (HCV), according to a study published online March 14 in the Journal of Hepatology.
Hélène Fontaine, M.D., from the Institut Pasteur Université Paris Descartes, and colleagues used data (January 1993 to December 2010) from the French national database CRISTAL to identify 31,433 kidney transplant recipients to assess the impact of HBV and HCV on patient and graft survival based on viral replication status.
The researchers found that 575 kidney transplant recipients had chronic hepatitis B, 1,060 had chronic hepatitis C, and 29,798 were not infected. Ten-year survival was lower in HCV-infected recipients (71.3 percent) versus those who were HBV-infected (81.2 percent) or noninfected (82.7 percent). Results were similar for 10-year kidney graft survival (HCV-infected, 50.6 percent versus HBV-infected, 62.3 percent or noninfected, 64.7 percent). Ten-year patient and graft survival in those with detectable HCV RNA was lower compared with matched controls, while patients with HCV and undetectable HCV RNA had higher 10-year survival versus matched controls but without significant differences in graft survival.
"Antiviral therapy should be systematically proposed to hepatitis B and/or hepatitis C-infected kidney transplant recipients or candidates to prevent the deleterious hepatic and extrahepatic impact of chronic viral replication," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.