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https://hdl.handle.net/2440/64177
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Type: | Journal article |
Title: | Adverse impact of Hepatitis C Virus Infection on Renal Replacement Therapy and Renal Transplant Patients in Australia and New Zealand |
Author: | Scott, D. Wong, J. Spicer, T. Dent, H. Mensah, F. McDonald, S. Levy, M. |
Citation: | Transplantation, 2010; 90(11):1165-1171 |
Publisher: | Lippincott Williams & Wilkins |
Issue Date: | 2010 |
ISSN: | 0041-1337 1534-6080 |
Statement of Responsibility: | David Scott, Jeffrey K. Wong, Tim Spicer, Hanna Dent, Fiona Mensah, Stephen McDonald, Miriam T. Levy |
Abstract: | Background. Understanding the impact of hepatitis C virus (HCV) infection in patients with end-stage renal disease before and after renal transplantation requires more data. We examined the outcomes of HCV antibody positive (HCVAb+) dialysis and renal transplant patients using the Australian and New Zealand Dialysis and Transplant registry. Methods. Two cohorts of dialysis (n=23,046) and transplant (n=7572) patients were identified. Survival outcomes, causes of mortality, and causes of graft failure were examined. Results. Dialysis Cohort: 362 (1.6%) were HCVAb+ve. The cause of end-stage renal disease in the HCVAb+ve group was more likely to be glomerulonephritis or diabetes. Survival figures were similar at 5 years (48% vs. 47%) and 10 years (22% and 20%) for HCVAb+ve and HCVAb negative (HCVAb−ve) groups; however, the adjusted hazard ratio (aHR) for mortality was increased, 1.25 (95% confidence interval [CI], 1.07–1.46), for the HCVAb+ve cohort. Liver failure was more likely. Renal Transplantation Cohort: 140 (1.8%) were HCVAb+ve. Patient survival among HCVAb+ve and HCVAb−ve groups was 77% vs. 90% and 50% vs. 79% at 5 and 10 years, respectively. The aHR for patient death was 2.38 (95%CI, 1.69–3.37). Higher rates of death due to cardiovascular disease (aHR=2.74), malignancy (aHR=2.52), and hepatic failure (aHR=22.1) were observed. The aHR for graft loss was 1.71 (95%CI, 1.28–2.29) for HCVAb+ve patients; and glomerulonephritis, chronic allograft neuropathy, and death were more frequent causes of graft failure. Conclusion. On dialysis, HCVAb+ve patients had a slightly worse outcome. After renal transplantation, the HCVAb+ve cohort had a markedly worse patient and graft outcome. The impact of viral eradication on these outcomes is unknown. |
Keywords: | Hepatitis C HCV End-stage renal disease Renal transplantation ANZDATA |
Rights: | © 2010 Lippincott Williams & Wilkins, Inc. |
DOI: | 10.1097/TP.0b013e3181f92548 |
Description (link): | http://www.ncbi.nlm.nih.gov/pubmed/20861806 |
Published version: | http://dx.doi.org/10.1097/tp.0b013e3181f92548 |
Appears in Collections: | Aurora harvest 5 Public Health publications |
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