Adverse impact of hepatitis C virus infection on renal replacement therapy and renal transplant patients in Australia and New Zealand

David R. Scott, Jeffrey K.W. Wong, Tim S. Spicer, Hanna Dent, Fiona K. Mensah, Stephen McDonald, Miriam T. Levy

Research output: Contribution to journalArticlepeer-review

113 Citations (Scopus)

Abstract

Background. Understanding the impact of hepatitis C virus (HCV) infection in patients with end-stage renal disease before and after renal transplantation requires more data. We examined the outcomes of HCV antibody positive (HCVAb+) dialysis and renal transplant patients using the Australian and New Zealand Dialysis and Transplant registry. Methods. Two cohorts of dialysis (n=23,046) and transplant (n=7572) patients were identified. Survival outcomes, causes of mortality, and causes of graft failure were examined. Results. Dialysis Cohort: 362 (1.6%) were HCVAb+ve. The cause of end-stage renal disease in the HCVAb+ve group was more likely to be glomerulonephritis or diabetes. Survival figures were similar at 5 years (48% vs. 47%) and 10 years (22% and 20%) for HCVAb+ve and HCVAb negative (HCVAb-ve) groups; however, the adjusted hazard ratio (aHR) for mortality was increased, 1.25 (95% confidence interval [CI], 1.07-1.46), for the HCVAb+ve cohort. Liver failure was more likely. Renal Transplantation Cohort: 140 (1.8%) were HCVAb+ve. Patient survival among HCVAb+ve and HCVAb-ve groups was 77% vs. 90% and 50% vs. 79% at 5 and 10 years, respectively. The aHR for patient death was 2.38 (95%CI, 1.69-3.37). Higher rates of death due to cardiovascular disease (aHR=2.74), malignancy (aHR=2.52), and hepatic failure (aHR=22.1) were observed. The aHR for graft loss was 1.71 (95%CI, 1.28-2.29) for HCVAb+ve patients; and glomerulonephritis, chronic allograft neuropathy, and death were more frequent causes of graft failure. Conclusion. On dialysis, HCVAb+ve patients had a slightly worse outcome. After renal transplantation, the HCVAb+ve cohort had a markedly worse patient and graft outcome. The impact of viral eradication on these outcomes is unknown.

Original languageEnglish
Pages (from-to)1165-1171
Number of pages7
JournalTransplantation
Volume90
Issue number11
DOIs
Publication statusPublished - 15 Dec 2010
Externally publishedYes

Keywords

  • ANZDATA
  • End-stage renal disease
  • HCV
  • Hepatitis C
  • Renal transplantation

ASJC Scopus subject areas

  • Transplantation

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