Behzad-Behbahani A, Mojiri A, Tabei S Z, Farhadi-Andarabi A, Pouransari R, Yaghobi R, Rahsaz M, Banihashemi M, Malek-Hosseini S A, Javid A, Bahador A, Reisjalali A, Behzadi S, Salehipour M, Salahl A, Davari R, Janghorban P, Torb A, Salah A R
Clinical Virology Section, Organ Transplant Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Transplant Proc. 2005 Sep;37(7):3045-7. doi: 10.1016/j.transproceed.2005.07.039.
Chronic liver disease resulting from hepatitis B virus (HBV) and hepatitis C virus (HCV) infections is still a major concern in kidney recipients. It is unclear whether HCV antibody status and markers of HBV infection are associated with renal dysfunction. Thus, we designed a study to investigate the incidence of HBV and HCV infection after renal transplantation and whether these infections alter graft function.
Fifty-eight patients who underwent renal transplantation participated in the study. Serum creatinine and aminotransferase levels were measured with standard automated analyzers. Anti-HCV antibodies were detected with an enzyme immunoassay, and a reverse transcriptase-polymerase chain reaction (RT-PCR) technique was used to test for HCV-RNA. Serological markers for HBV (HBsAg and anti-HBc antibody) were detected by enzyme immunoassay. All samples from patients who were seropositive for HBsAg or anti-HBc antibody were PCR-tested for HBV-DNA. A serum sample collected from living donors was tested for anti-HCV antibodies and serological markers for HBV. Serum creatinine and aminotransferase levels were also measured in living donors.
Anti-HCV was not detected in serum samples of any cases before transplantation. However, 10 (17.2%) tested positive after transplantation. HCV-RNA was detected in 2 of the 10 patients (3.4% of all patients). None of the pretransplantation serum samples tested positive for HBsAg. However, anti-HBc antibody was identified in 8 (13.8%) of the 58 patients.. No HBV DNA was detected in serum samples of the patients with anti-HBc or HBsAg-positive. HBsAg was only detected in 1 (1.7%) recipient after transplantation. None of the 58 patients showed clinical signs or symptoms of renal dysfunction during the study period.
Our data suggest that, neither HBV nor HCV infection appears to cause or contribute to renal dysfunction in the early period (1 year) after renal transplantation. Nevertheless, a long-term consequence of chronic HBV or HCV liver disease or graft loss is not impossible in renal transplant recipients.
由乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染导致的慢性肝病仍是肾移植受者的主要担忧问题。目前尚不清楚HCV抗体状态和HBV感染标志物是否与肾功能不全相关。因此，我们设计了一项研究，以调查肾移植后HBV和HCV感染的发生率，以及这些感染是否会改变移植肾功能。
58例接受肾移植的患者参与了本研究。使用标准自动分析仪测量血清肌酐和转氨酶水平。采用酶免疫测定法检测抗HCV抗体，并使用逆转录聚合酶链反应（RT-PCR）技术检测HCV-RNA。通过酶免疫测定法检测HBV的血清学标志物（HBsAg和抗HBc抗体）。对所有HBsAg或抗HBc抗体血清学阳性患者的样本进行HBV-DNA的PCR检测。检测从活体供者采集的血清样本中的抗HCV抗体和HBV血清学标志物。同时也测量活体供者的血清肌酐和转氨酶水平。
移植前所有病例的血清样本中均未检测到抗HCV。然而，移植后有10例（17.2%）检测呈阳性。10例患者中有2例检测到HCV-RNA（占所有患者的3.4%）。移植前所有血清样本的HBsAg检测均为阴性。然而，58例患者中有8例（13.8%）检测到抗HBc抗体。抗HBc或HBsAg阳性患者的血清样本中均未检测到HBV DNA。仅在1例（1.7%）移植后受者中检测到HBsAg。在研究期间，58例患者均未出现肾功能不全的临床体征或症状。
我们的数据表明，在肾移植后的早期（1年），HBV和HCV感染似乎均未导致或促成肾功能不全。然而，对于肾移植受者而言，慢性HBV或HCV肝病的长期后果或移植肾丢失并非不可能。
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