Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, Avda. de Córdoba s/n, Madrid, Spain.
Transplantation. 2011 Sep 15;92(5):543-9. doi: 10.1097/TP.0b013e318225dbae.
There is scarce information regarding the role of hepatitis C virus (HCV) infection in the development of infectious complications after kidney transplantation (KT).
We prospectively analyzed all KT recipients included in the Spanish Network for the Research of Infection in Transplantation cohort from September 2003 to February 2005 with a posttransplant follow-up of 3 years and compared the incidence of both overall and specific infections according to the pretransplant anti-HCV antibody status.
Of 1302 analyzed recipients, 105 (8.1%) were anti-HCV positive. These patients presented a higher rate of previous transplant (P<0.001), had a lower donor age (P=0.055), higher transfusion requirements (P=0.037), and more frequently received induction therapy with antithymocyte antibodies (P=0.005). We found no differences between anti-HCV-positive and -negative recipients in the overall incidence rate of infection (0.82 vs. 0.74 episodes per 1000 transplant-days, respectively). Nevertheless, anti-HCV-positive recipients had a higher cumulative incidence of bloodstream (P=0.01) and upper urinary tract infections (P=0.037). Anti-HCV status emerged by logistic regression as an independent risk factor only for bloodstream infection (odds ratio, 3.14; 95% confidence interval, 1.19-8.24; P=0.020). Anti-HCV-positive recipients also experimented a higher rate of recurrent acute rejection (P=0.045) and retransplantation (P=0.017), with no differences in overall mortality.
According to the results of the Spanish Network for the Research of Infection in Transplantation cohort, the incidence of some potentially severe posttransplant infections may be increased in anti-HCV-positive KT recipients.
关于丙型肝炎病毒（HCV）感染在肾移植（KT）后感染性并发症发展中的作用，相关信息十分有限。
我们前瞻性分析了 2003 年 9 月至 2005 年 2 月间纳入西班牙移植感染研究网络队列的所有 KT 受者，移植后随访 3 年，并根据移植前抗 HCV 抗体状态比较了总感染和特定感染的发生率。
在分析的 1302 例受者中，105 例（8.1%）抗 HCV 阳性。这些患者既往移植率更高（P<0.001），供者年龄更小（P=0.055），输血需求更高（P=0.037），更常接受抗胸腺细胞抗体诱导治疗（P=0.005）。我们未发现抗 HCV 阳性和阴性受者的感染总发生率存在差异（分别为 0.82 和 0.74 例/1000 移植日）。然而，抗 HCV 阳性受者的血流感染（P=0.01）和上尿路感染（P=0.037）的累积发生率更高。通过逻辑回归，抗 HCV 状态仅被确定为血流感染的独立危险因素（优势比，3.14；95%置信区间，1.19-8.24；P=0.020）。抗 HCV 阳性受者还经历了更高的急性排斥反应复发率（P=0.045）和再次移植率（P=0.017），但总体死亡率无差异。
根据西班牙移植感染研究网络队列的结果，抗 HCV 阳性 KT 受者可能会增加某些潜在严重的移植后感染的发生率。
