HEPATITIS C IS A POOR PROGNOSTIC INDICATOR IN BLACK KIDNEY TRANSPLANT RECIPIENTS
HEPATITIS C IS A POOR PROGNOSTIC INDICATOR IN BLACK KIDNEY TRANSPLANT RECIPIENTS
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丙型肝炎是黑人肾移植受者的不良预后指标
DOI：
10.1097/00007890-199306000-00014
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发表时间：
1993
期刊：
影响因子：
6.2
通讯作者：
Helen H. Lee
中科院分区：
文献类型：
--
作者：
C. Fritsche;J. Brandes;S. Delaney;S. Gallagher;J. Menitove;Lisa Rich;Cornelius Scannell;P. Swanson;Helen H. Lee
背景丙型肝炎在肾移植受者中的意义尚不清楚。在某些中心，移植候选人中丙型肝炎抗体的流行率高达50%。方法采用第二代免疫分析法对1979年1月至1990年3月间在威斯康星州医学院接受肾移植的640例患者的冻存血清进行丙型肝炎抗体检测。从所有丙型肝炎抗体阳性（抗-HCV+）患者和256随机选择的丙型肝炎抗体阴性（抗-HCV-）对照组的图表进行了审查。确定这两组的患者和移植物存活率。结果抗-HCV阳性率为8.3%。在抗-HCV+组中，黑人和静脉注射吸毒者的比例不成比例。在抗-HCV阳性患者中，18.9%发生了与种族无关的慢性肝炎。黑人抗HCV阳性患者的5年移植物存活率为28±11%，而黑人抗HCV阴性患者为67±7%（P=0.003）。黑人抗-HCV-、白色抗-HCV-和白色抗-HCV+患者的移植物存活率相似。抗-HCV不是患者总体生存或再生障碍性贫血和恶性肿瘤（包括肝细胞癌）发展的不良预后指标。结论抗HCV是黑人肾移植存活率降低的一个重要危险因素，除了静脉注射药物滥用。黑人抗-HCV患者的移植物存活率与白色移植受者相似，表明抗-HCV可能是在大多数移植程序中观察到的黑人移植物存活率较差的一个标志物。肾移植受者中的抗-HCV增加了移植后慢性肝炎发展的风险。
Background The significance of hepatitis C in kidney transplant recipients is unclear. The prevalence of antibodies to hepatitis C among candidates for transplantation is up to 50% in some centers. Methods We screened 640 frozen serum samples obtained pretransplantation from all kidney recipients at the Medical College of Wisconsin between January 1979 and March 1990 for antibody to hepatitis C using the second generation immunoassay. Charts were reviewed from all hepatitis C antibody-positive (anti-HCV+) patients and 256 randomly chosen hepatitis C antibody negative (anti-HCV-) controls. Actuarial patient and graft survival in these two groups were determined. Results The prevalence of anti-HCV was 8.3%. Blacks and i.v. drug users were disproportionately represented in the anti-HCV+ group. Of the anti-HCV+ patients, 18.9% developed chronic hepatitis independent of race. Black anti-HCV+ patients had a 5-year graft survival of 28±11% compared to 67±7% in black anti-HCV-patients (P=0.003). Black anti-HCV-, white anti-HCV—, and white anti-HCV+ patients all had similar graft survival. Anti-HCV was not a poor prognostic indicator for overall patient survival or the development of aplastic anemia and malignancies including hepatocellular carcinoma. Conclusions Anti-HCV is a significant risk factor for reduced kidney graft survival in blacks apart from i.v. drug abuse. Black anti-HCV—patients had graft survival similar to white transplant recipients, indicating that anti-HCV may be one marker for the poorer graft survival in blacks that has been observed in most transplant programs. Anti-HCV in kidney transplant recipients increases the risk for the development of chronic hepatitis post-transplant.