Santos L, Alves R, Macario F, Parada B, Campos M, Mota A
Department of Nephrology, Rainha Santa Isabel Hospital, Torres Novas, Portugal.
Transplant Proc. 2009 Apr;41(3):880-2. doi: 10.1016/j.transproceed.2009.01.074.
The impacts of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections on patient and renal graft survivals are controversial. This study sought to evaluate the effects of pretransplantation HCV and HBV infections on renal transplant patients and their grafts at our center.
We retrospectively examined 1224 renal transplantations performed between 1992 and 2006, including 28 HBsAg positive; 64, anti-HCV; 9, anti-HCV plus HBsAg positive; and 1123, negative for anti-HCV and HBsAg. The mean posttransplantation follow-up was 5.6 +/- 4.1 years.
The prevalences of HBV infection were 6.2% in 1994 and 2.3% in 2006 and those of HCV infection were 6.8% in 1998 and 5.2% in 2006. The rejection rate was higher among HBV+ (46.4%) and HCV+ (40.6%) groups than the negative groups (31.5%), but it was not significant. There were no significant differences in patient and graft survivals among the groups. The major cause of patient death was liver failure among patients with concomitant HBV+ and HCV+ infections and cardiovascular disease among HCV+ and negative patients.
There has been a decrease in the prevalence of recipients with hepatitis virus infections over the last 15 years. Patient and graft survivals were not affected by HCV or HBV infection.
丙型肝炎病毒（HCV）和乙型肝炎病毒（HBV）感染对患者及肾移植存活情况的影响存在争议。本研究旨在评估我院中心肾移植术前HCV和HBV感染对肾移植患者及其移植物的影响。
我们回顾性研究了1992年至2006年间进行的1224例肾移植手术，其中28例HBsAg阳性；64例抗-HCV阳性；9例抗-HCV和HBsAg均阳性；1123例抗-HCV和HBsAg均阴性。移植后平均随访时间为5.6±4.1年。
1994年HBV感染率为6.2%，2006年为2.3%；1998年HCV感染率为6.8%，2006年为5.2%。HBV阳性（46.4%）和HCV阳性（40.6%）组的排斥反应发生率高于阴性组（31.5%），但差异无统计学意义。各组患者及移植物存活率无显著差异。合并HBV和HCV感染患者的主要死亡原因是肝衰竭，HCV阳性和阴性患者的主要死亡原因是心血管疾病。
在过去15年中，肝炎病毒感染受者的患病率有所下降。HCV或HBV感染不影响患者及移植物存活率。
