The burden of anti-HCV genotye-4 positivity in renal transplant recipients: 8 years follow-up

Whether renal transplant recipients with anti-HCV antibodies positivity and normal liver function tests within the first year after transplantation have different morbidity and mortality and graft failure compared to anti-HCV-negative recipients remains controversial. In this retrospective study, on 411 renal transplant recipients, we analyzed grafts morbidity, survival, and liver function tests over a period of 8 years. Patients were stratified according to their anti-HCV antibody status 1 year after transplantation into anti-HCV-positive and HCV-negative patients. The presence of normal liver function tests was mandatory at inclusion. All patients received the same immunosuppressive protocol consisting of cyclosporine A, mycophenolate mofetil and steroids. One year after transplantation, 137 patients were anti-HCV negative (33 %) while the rest 274 (67 %) were positive. At 5 years of follow-up, the study population consisted of 205 patients (71 patients, 35 % with anti-HCV negativity, and 134, 65 % with positivity). At the end of the study, only 144 patients were followed up (43 patients, 30 % with negative anti-HCV and 101 patients, 70 %, with positivity). We found that graft survival was not different between both groups. Moreover, serum creatinine showed a trend to be lower in HCV-positive patients compared to negative group although difference was not statistically significant. The number of graft loss was not different between both groups. Moreover, there was no difference between both groups as regards prevalence of acute rejection, diabetes mellitus, hypertension, CMV disease and proteinuria. We can conclude that anti-HCV positivity for 8 years in patients with normal liver function tests at 1 year does not impact graft morbidity and patient survival.