Hepatitis C Viral Markers in the Recipients Before and After Kidney Transplantation

Shin, Jeong Won; Park, Nam Jae; Kim, Hyon Suk; Kim, Myung Soo; Kim, Soon Il; Kim, Yoo Sun

Abstract

BACKGROUND
Hepatitis C virus (HCV) has been identified as one of the most frequent causative agent of posttransplant non-A, non-B hepatitis, but the significance of anti-HCV antibodies after transplantation remains controversial. In the present study, we performed anti-HCV and HCV-RNA RT-PCR (HCV PCR) in the kidney recipients to assess the incidence and the outcome of HCV markers after transplantation.
MATERIALS AND METHODS
In randomly selected 95 patients' paired sera (before and after transplant samples, respectively), we performed anti-HCV test by Abbott HCV EIA 3.0. We also performed HCV PCR in 80 paired sera of the 95 patients. We evaluated the incidence of anti-HCV and HCV PCR and compared the results in the kidney recipients between anti-HCV test and HCV PCR before and after transplantation.
RESULTS
In the recipients' sera before transplantation, 16 (16.8%) among 95 sera were anti-HCV positive and 27 (33.8%) among 80 sera were HCV RNA positive. Among the 80 pretransplant sera performed HCV PCR, 23 (28.8%) discordant results were noted between anti-HCV and HCV PCR, and 17 sera among these were HCV PCR positive and anti-HCV negative. A seroconversion from anti-HCV negative to positive after transplantation was observed in 10 sera, but a conversion from positive to negative was not observed. In case of HCV PCR, a conversion from negative to positive was observed in 21 paired sera, and positive to negative in 13 paired sera.
CONCLUSIONS
Our study indicated that disapperance of anti-HCV antibodies after transplantation in kidney recipients was rare. The overall concordance rates between anti-HCV test and HCV PCR in the recipients before and after renal transplantation were lower than other non-transplanted groups reported, and it may be due to the immunosuppressive therapy or the changes in immunoregulatory function of the patients. Further study such as follow-up liver function tests or liver biopsy will be needed for accurate decision about posttransplant HCV status of kidney recipients.