impact of hepatitis C virus infection on kidney transplantation outcomes: a systematic review of 18 observational studies

ABSTRACT

Hepatitis C virus [HCV] infection occursin 0% to 51% of dialysis patients, and many HCV-positive patients are urged to undergo kidney transplantation. However, the outcome of renal transplantation in HCV-positive recipients is unknown. Our review aimed to address the outcomes of renal transplantation recipients [RTRs] following kidney transplantation. We selected studies that used the adjusted relative risk [aRR] and 95% CI of all-cause mortality and graft loss in HCV-positive compared with HCV-negative RTRs as study endpoints. Cox proportional hazard analysis was usedin all studies to calculate the independent effects of HCV infection on RTR outcomes. Sixteen retrospective cohort studies and 2 clinical trials were selected for our review. Sixteen studies were related to patient survival, and 12 examined graft survival. The combined hazard ratio in HCV-infected recipients was 1.69-fold [1.33-1.97, p< 0.0001] and 1.56 times [1.22-2.004, p < 0.0001] greater than that of HCV-negative recipients for mortality and graft loss, respectively. Although HCV-infected RTRs have worseoutcomes than HCV-negative RTRS, kidney transplantation is the preferred treatment for patients with HCV infection and end-stage renal disease