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HCV, HBV viral control improves kidney transplant survival rates

Kidney transplant recipients with hepatitis B and hepatitis C in whom viral replication was controlled had similar overall and graft survival rates as patients without viral hepatitis, according to data published in Journal of Hepatology.

“The present results suggest ... that antiviral therapy should be systematically proposed to HBV- and/or HCV-infected [kidney transplant recipients] or kidney transplant candidates to prevent the deleterious hepatic and extrahepatic impact of chronic viral replication,” Hélène Fontaine, MD, from the Cochin Hospital in Paris, France, and colleagues wrote.

Fontaine and colleagues compared the overall and graft survival rates of kidney transplant recipients with either HBV or HCV and 29,798 patients without viral hepatitis. Virological data showed that 157 patients with HBV from 167 available records had controlled viral replication. HCV RNA was undetectable in 155 of 441 patients with HCV virological data.

Ten-year overall survival in patients with HCV (71.3%) was significantly lower than those with HBV (81.2%; P = .0004) and patients without viral hepatitis (82.7%; P < .0001). Similarly, 10-year graft survival was significantly lower in those with HCV (50.6%) than those with HBV (62.3%; P < .0001) and those without viral hepatitis (64.7%; P < .0001).

However, 10-year overall survival rates were significantly higher in patients without viral replication than those with viral replication among patients without cirrhosis (89.4% vs. 79.9%; HR = 2.5; 95% CI, 1.3-4.9). Ten-year graft survival rates were also higher (70.4% vs. 54.1%; HR = 1.69; 95% CI, 1.1-2.6).

“Future studies are needed to confirm what has been previously reported in high-risk population for HCV (intravenous drugs user and men who have sex with men), namely whether systematic antiviral treatment can decrease or even eliminate the incidence of viral hepatitis in dialysis patients and [kidney transplant recipients].” – by Talitha Bennett

Disclosure: Fontaine reports receiving personal fees from AbbVie, Bristol-Myers Squibb, Gilead, Janssen and Merck Sharp & Dohme. Please see the full study for all other authors’ relevant financial disclosures.