Introduction: The long-term impact of hepatitis C virus (HCV) infection in renal allograft remains controversial. Some reports have indicated that HCV-infected kidney recipients had poorer graft survival compared to HCV-negative patients. However, the impact of HCV on the development of interstitial fibrosis (IF) and transplant glomerulopathy (TG) is not clear enough. Therefore, we designed this study to identify the influence of HCV infection on the development of IF and TG in Pediatric Renal Transplant (Tx) Patients.
Methods: Total 40 patients with a mean age of 16,7 ± 2,2 years (12–20) included in the study. Development of both IF and TG in follow-up biopsies compared between HCV-positive (n = 16) and HCV negative (n = 24) recipients. Also, the number of acute rejection (AR) episodes and graft survival compared between HCV-positive and negative patients. Mean follow-up time was 84,8 ± 32 months.
Results: The frequency of the development of IF and TG, 12 and 24 months after Tx was higher in HCV-positive patients compared to HCV-negative recipients (p < 0.01). The time between Tx and the development of IF and TG was 14,9 ± 4,4 months and 25,9 ± 12,3 months respectively for HCV-positive patients. It was 29,4 ± 11,6 months and 42,6 ± 5,4 months respectively for HCV-negative patients. A significant difference found between these two groups in regards to the development of IF and TG (p = 0.001 for both). HCV-positive patients (1,44 ± 1) had greater numbers of AR episodes than did HCV-negative recipients (0,67 ± 0,9) (p < 0.05). Overall the 3-, 5- and 10-year graft survival was 69%, 50%, and 0% respectively for HCV-positive patients. It was 96%, 50%, and 11% respectively for HCV-negative patients (p < 0.05).
Conclusion: HCV-positive patients had higher incidences of the early development of IF and TG. They also had higher AR episodes and shorter graft survival than did HCV-negative recipients. The negative role of HCV in the long-term renal allograft survival can be explained by the possible triggering effect of HCV on the development of early IF and TG through augmenting AR episodes.