Hepatitis c infection in kidney transplant candidates and recipients

Official reprint from UpToDate www.uptodate.com ©2017 UpToDate ® ® Authors Marion Muche, MD Seema Baid-Agrawal, MD Section Editors Daniel C Brennan, MD, FACP Martin S Hirsch, MD Adrian M

Official reprint from UpToDate www.uptodate.com ©2017 UpToDate

®

®

Authors

Marion Muche, MD

Seema Baid-Agrawal, MD

Section Editors Daniel C Brennan, MD, FACP Martin S Hirsch, MD

Adrian M Di Bisceglie, MD

Deputy Editors Albert Q Lam, MD Allyson Bloom, MD

Hepatitis C infection in kidney transplant candidates and

recipients

INTRODUCTION

Hepatitis C virus (HCV) causes renal disease in native and transplanted kidneys HCV-infected renal

transplant recipients have worse patient and allograft survival after transplantation compared with noninfected renal transplant recipients

Early detection, prevention, and treatment of HCV-related renal disease after kidney transplantation could

improve posttransplant outcomes in this population [1

This topic reviews HCV infection in the renal transplant recipient HCV infection among dialysis patients, in

the renal transplant donor, and in the general population is discussed elsewhere (See "Hepatitis C virus

infection in kidney donors" and "Hepatitis C virus infection in patients on maintenance dialysis" and "Clinical

manifestations and natural history of chronic hepatitis C virus infection" and "Diagnosis and evaluation of

chronic hepatitis C virus infection" and "Overview of the management of chronic hepatitis C virus infection".)

EPIDEMIOLOGY

The reported prevalence of HCV infection among renal transplant recipients is approximately 1.8 to 8 percent [2-6] Most HCV-infected transplant recipients are infected prior to transplant, while on dialysis [5] The

transmission of HCV through kidney transplantation is rare due to screening of donors [5] (See "Hepatitis C virus infection in kidney donors".)

SCREENING OF TRANSPLANT CANDIDATES

We agree with the 2008 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines that all transplant

candidates should be screened for HCV infection [7] Transplant candidates who were previously

successfully treated for HCV infection should be rescreened at least annually

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4/2/2017 Hepatitis C infection in kidney transplant candidates and recipients

References

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Literature review current through: Jan 2017 | This topic last updated: thg 4 25, 2016

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1 Kidney Disease: Improving Global Outcomes (KDIGO) KDIGO clinical practice guidelines for the

prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease Kidney Int

Suppl 2008; :S1

2 Kliem V, Burg M, Haller H, et al Relationship of hepatitis B or C virus prevalences, risk factors, and

outcomes in renal transplant recipients: analysis of German data Transplant Proc 2008; 40:909

3 Scott DR, Wong JK, Spicer TS, et al Adverse impact of hepatitis C virus infection on renal

replacement therapy and renal transplant patients in Australia and New Zealand Transplantation 2010; 90:1165

4 Santos L, Alves R, Macario F, et al Impact of hepatitis B and C virus infections on kidney

transplantation: a single center experience Transplant Proc 2009; 41:880

5 Baid-Agrawal S, Pascual M, Moradpour D, et al Hepatitis C virus infection and kidney transplantation

in 2014: what's new? Am J Transplant 2014; 14:2206

6 Baid-Agrawal S, Schindler R, Reinke P, et al Prevalence of occult hepatitis C infection in chronic

hemodialysis and kidney transplant patients J Hepatol 2014; 60:928

7 Kidney Disease: Improving Global Outcomes (KDIGO) KDIGO clinical practice guidelines for the

prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease Kidney Int

Suppl 2008; :S1

8 El-Sherif A, Elbahrawy A, Aboelfotoh A, et al High false-negative rate of anti-HCV among Egyptian

patients on regular hemodialysis Hemodial Int 2012; 16:420

9 Mathurin P, Mouquet C, Poynard T, et al Impact of hepatitis B and C virus on kidney transplantation

outcome Hepatology 1999; 29:257

10 Zylberberg H, Nalpas B, Carnot F, et al Severe evolution of chronic hepatitis C in renal transplantation:

a case control study Nephrol Dial Transplant 2002; 17:129

11 Pawa S, Ehrinpreis M, Mutchnick M, et al Percutaneous liver biopsy is safe in chronic hepatitis C

patients with end-stage renal disease Clin Gastroenterol Hepatol 2007; 5:1316

12 Ahmad A, Hasan F, Abdeen S, et al Transjugular liver biopsy in patients with end-stage renal

disease J Vasc Interv Radiol 2004; 15:257

13 Eason JD, Gonwa TA, Davis CL, et al Proceedings of Consensus Conference on Simultaneous Liver

Kidney Transplantation (SLK) Am J Transplant 2008; 8:2243

14 Paramesh AS, Davis JY, Mallikarjun C, et al Kidney transplantation alone in ESRD patients with

hepatitis C cirrhosis Transplantation 2012; 94:250

15 Periera BJ, Wright TL, Schmid CH, Levey AS The impact of pretransplantation hepatitis C infection on the outcome of renal transplantation Transplantation 1995; 60:799

16 Stempel CA, Lake J, Kuo G, Vincenti F Hepatitis C its prevalence in end-stage renal failure patients

and clinical course after kidney transplantation Transplantation 1993; 55:273

Patient or Caregiver

17 Roth D, Zucker K, Cirocco R, et al The impact of hepatitis C virus infection on renal allograft

recipients Kidney Int 1994; 45:238

18 Ynares C, Johnson HK, Kerlin T, et al Impact of pretransplant hepatitis C antibody status upon

long-term patient and renal allograft survival a 5- and 10-year follow-up Transplant Proc 1993; 25:1466

19 Fritsche C, Brandes JC, Delaney SR, et al Hepatitis C is a poor prognostic indicator in black kidney

transplant recipients Transplantation 1993; 55:1283

20 Lee SW, Kang SW, Choi KH, et al Clinical outcome of anti-HCV(+) renal allograft recipients

Transplant Proc 1996; 28:1501

21 Toth CM, Pascual M, Chung RT, et al Hepatitis C virus-associated fibrosing cholestatic hepatitis after renal transplantation: response to interferon-alpha therapy Transplantation 1998; 66:1254

22 Muñoz De Bustillo E, Ibarrola C, Colina F, et al Fibrosing cholestatic hepatitis in hepatitis C

virus-infected renal transplant recipients J Am Soc Nephrol 1998; 9:1109

23 Roth D, Gaynor JJ, Reddy KR, et al Effect of kidney transplantation on outcomes among patients with hepatitis C J Am Soc Nephrol 2011; 22:1152

24 Alric L, Di-Martino V, Selves J, et al Long-term impact of renal transplantation on liver fibrosis during

hepatitis C virus infection Gastroenterology 2002; 123:1494

25 Manuel O, Baid-Agrawal S, Moradpour D, Pascual M Immunosuppression in hepatitis C virus-infected patients after kidney transplantation Contrib Nephrol 2012; 176:97

26 European Association For The Study Of The Liver, European Organisation For Research And

Treatment Of Cancer EASL-EORTC clinical practice guidelines: management of hepatocellular

carcinoma J Hepatol 2012; 56:908

27 Burstein DM, Rodby RA Membranoproliferative glomerulonephritis associated with hepatitis C virus

infection J Am Soc Nephrol 1993; 4:1288

28 Rahamimov R, Ilan Y, Eid A, et al Hepatitis C-associated cryoglobulinemia after liver transplantation

Transplantation 1995; 60:1050

29 Cantarell MC, Charco R, Capdevila L, et al Outcome of hepatitis C virus-associated

membranoproliferative glomerulonephritis after liver transplantation Transplantation 1999; 68:1131

30 Cruzado JM, Carrera M, Torras J, Grinyó JM Hepatitis C virus infection and de novo glomerular lesions

in renal allografts Am J Transplant 2001; 1:171

31 Hammoud H, Haem J, Laurent B, et al Glomerular disease during HCV infection in renal

transplantation Nephrol Dial Transplant 1996; 11 Suppl 4:54

32 Roth D, Cirocco R, Zucker K, et al De novo membranoproliferative glomerulonephritis in hepatitis C

virus-infected renal allograft recipients Transplantation 1995; 59:1676

33 Cruzado JM, Gil-Vernet S, Ercilla G, et al Hepatitis C virus-associated membranoproliferative

glomerulonephritis in renal allografts J Am Soc Nephrol 1996; 7:2469

34 Gallay BJ, Alpers CE, Davis CL, et al Glomerulonephritis in renal allografts associated with hepatitis

C infection: a possible relationship with transplant glomerulopathy in two cases Am J Kidney Dis

1995; 26:662

35 Morales JM, Pascual-Capdevila J, Campistol JM, et al Membranous glomerulonephritis associated

with hepatitis C virus infection in renal transplant patients Transplantation 1997; 63:1634

36 Baid S, Pascual M, Williams WW Jr, et al Renal thrombotic microangiopathy associated with

anticardiolipin antibodies in hepatitis C-positive renal allograft recipients J Am Soc Nephrol 1999;

10:146

37 Baid-Agrawal S, Farris AB 3rd, Pascual M, et al Overlapping pathways to transplant glomerulopathy:

chronic humoral rejection, hepatitis C infection, and thrombotic microangiopathy Kidney Int 2011;

80:879

38 Cosio FG, Roche Z, Agarwal A, et al Prevalence of hepatitis C in patients with idiopathic

glomerulopathies in native and transplant kidneys Am J Kidney Dis 1996; 28:752

39 Cosio FG, Sedmak DD, Henry ML, et al The high prevalence of severe early posttransplant renal

allograft pathology in hepatitis C positive recipients Transplantation 1996; 62:1054

40 Gloor JM, Sethi S, Stegall MD, et al Transplant glomerulopathy: subclinical incidence and association with alloantibody Am J Transplant 2007; 7:2124

4/2/2017 Hepatitis C infection in kidney transplant candidates and recipients

41 Fabrizi F, Martin P, Dixit V, et al Post-transplant diabetes mellitus and HCV seropositive status after

renal transplantation: meta-analysis of clinical studies Am J Transplant 2005; 5:2433

42 Kamar N, Toupance O, Buchler M, et al Evidence that clearance of hepatitis C virus RNA after

alpha-interferon therapy in dialysis patients is sustained after renal transplantation J Am Soc Nephrol 2003;

14:2092

43 Delgado-Borrego A, Casson D, Schoenfeld D, et al Hepatitis C virus is independently associated with increased insulin resistance after liver transplantation Transplantation 2004; 77:703

44 Shintani Y, Fujie H, Miyoshi H, et al Hepatitis C virus infection and diabetes: direct involvement of the virus in the development of insulin resistance Gastroenterology 2004; 126:840

45 Baid-Agrawal S, Frei U, Reinke P, et al Impaired insulin sensitivity as an underlying mechanism

linking hepatitis C and posttransplant diabetes mellitus in kidney recipients Am J Transplant 2009;

9:2777

46 Burra P, Buda A, Livi U, et al Occurrence of post-transplant lymphoproliferative disorders among over

thousand adult recipients: any role for hepatitis C infection? Eur J Gastroenterol Hepatol 2006;

18:1065

47 Aravindan AN, Moger V, Sakhuja V, et al Hepatitis C virus related lymphoproliferative disorder in a

renal transplant recipient Int Urol Nephrol 2006; 38:355

48 Caillard S, Lelong C, Pessione F, et al Post-transplant lymphoproliferative disorders occurring after

renal transplantation in adults: report of 230 cases from the French Registry Am J Transplant 2006;

6:2735

49 Brunkhorst R, Kliem V, Koch KM Recurrence of membranoproliferative glomerulonephritis after renal

transplantation in a patient with chronic hepatitis C Nephron 1996; 72:465

50 Hestin D, Guillemin F, Castin N, et al Pretransplant hepatitis C virus infection: a predictor of

proteinuria after renal transplantation Transplantation 1998; 65:741

51 Mahmoud IM, Elhabashi AF, Elsawy E, et al The impact of hepatitis C virus viremia on renal graft and patient survival: a 9-year prospective study Am J Kidney Dis 2004; 43:131

52 Romero E, Galindo P, Bravo JA, et al Hepatitis C virus infection after renal transplantation Transplant Proc 2008; 40:2933

53 Recommendations for Testing, Managing, and Treating Hepatitis C Joint panel from the American

Association of the Study of Liver Diseases and the Infectious Diseases Society of America

http://www.hcvguidelines.org/ (Accessed on August 01, 2016)

54 European Association for Study of Liver EASL Recommendations on Treatment of Hepatitis C 2015 J Hepatol 2015; 63:199

55 World Health Organization Guidelines for the screening, care, adn treatment of persons with hepatitis

C infection April 2014 http://apps.who.int/iris/bitstream/10665/111747/1/9789241548755_eng.pdf?

ua=1 (Accessed on April 14, 2014)

56 Ozgür O, Boyacioğlu S, Telatar H, Haberal M Recombinant alpha-interferon in renal allograft

recipients with chronic hepatitis C Nephrol Dial Transplant 1995; 10:2104

57 Harihara Y, Kurooka Y, Yanagisawa T, et al Interferon therapy in renal allograft recipients with chronic hepatitis C Transplant Proc 1994; 26:2075

58 Rostaing L, Izopet J, Baron E, et al Preliminary results of treatment of chronic hepatitis C with

recombinant interferon alpha in renal transplant patients Nephrol Dial Transplant 1995; 10 Suppl 6:93

59 Chan TM, Lok AS, Cheng IK, Ng IO Chronic hepatitis C after renal transplantation Treatment with

alpha-interferon Transplantation 1993; 56:1095

60 Fabrizi F, Penatti A, Messa P, Martin P Treatment of hepatitis C after kidney transplant: a pooled

analysis of observational studies J Med Virol 2014; 86:933

61 Wei F, Liu J, Liu F, et al Interferon-based anti-viral therapy for hepatitis C virus infection after renal

transplantation: an updated meta-analysis PLoS One 2014; 9:e90611

62 Sperl J, Petrasek J, Spicak J, Viklicky O Acute rejection of non-functional allograft in kidney

transplant recipients with hepatitis C treated with peginterferon-alpha 2a J Hepatol 2008; 49:461

63 Wéclawiack H, Kamar N, Mehrenberger M, et al Alpha-interferon therapy for chronic hepatitis C may

induce acute allograft rejection in kidney transplant patients with failed allografts Nephrol Dial

Transplant 2008; 23:1043.

64

http://www.easl.eu/research/our-contributions/clinical-practice-guidelines/detail/recommendations-on-treatment-of-hepatitis-c-2015

65 Sawinski D, Kaur N, Ajeti A, et al Successful Treatment of Hepatitis C in Renal Transplant Recipients With Direct-Acting Antiviral Agents Am J Transplant 2016; 16:1588

66 Kamar N, Marion O, Rostaing L, et al Efficacy and Safety of Sofosbuvir-Based Antiviral Therapy to

Treat Hepatitis C Virus Infection After Kidney Transplantation Am J Transplant 2016; 16:1474

67 Colombo M, Aghemo A, Liu H, et al Treatment With Ledipasvir-Sofosbuvir for 12 or 24 Weeks in

Kidney Transplant Recipients With Chronic Hepatitis C Virus Genotype 1 or 4 Infection: A

Randomized Trial Ann Intern Med 2017; 166:109

68 Charlton M, Everson GT, Flamm SL, et al Ledipasvir and Sofosbuvir Plus Ribavirin for Treatment of

HCV Infection in Patients With Advanced Liver Disease Gastroenterology 2015; 149:649

69 Gutierrez JA, Carrion AF, Avalos D, et al Sofosbuvir and simeprevir for treatment of hepatitis C virus

infection in liver transplant recipients Liver Transpl 2015; 21:823

70 Pungpapong S, Aqel B, Leise M, et al Multicenter experience using simeprevir and sofosbuvir with or

without ribavirin to treat hepatitis C genotype 1 after liver transplant Hepatology 2015; 61:1880

71 Saab S, Greenberg A, Li E, et al Sofosbuvir and simeprevir is effective for recurrent hepatitis C in liver

transplant recipients Liver Int 2015; 35:2442

72 Kwo PY, Mantry PS, Coakley E, et al An interferon-free antiviral regimen for HCV after liver

transplantation N Engl J Med 2014; 371:2375

73 American Association of the Study of Liver Disease (AASLD) guidelines http://www.hcvguidelines.org

(Accessed on May 04, 2015)

74 Kiser JJ, Burton JR Jr, Everson GT Drug-drug interactions during antiviral therapy for chronic hepatitis

C Nat Rev Gastroenterol Hepatol 2013; 10:596

75 Mogalian E, German P, Kearney BP, et al Use of Multiple Probes to Assess Transporter- and

Cytochrome P450-Mediated Drug-Drug Interaction Potential of the Pangenotypic HCV NS5A Inhibitor

Velpatasvir Clin Pharmacokinet 2016; 55:605

76 Mogalian E, Shen G, Moorehead L, et al Drug-drug interaction profile of sofosbuvir/velpatasvir

fixed-dose combination Presented at the 51st Annual Meeting of the European Association for the Study of the Liver (EASL), Barcelona, Spain, April 13-17, 2016

77 Zaltzman JS, Nash M, Chiu R, Prasad R The benefits of renin-angiotensin blockade in renal transplant recipients with biopsy-proven allograft nephropathy Nephrol Dial Transplant 2004; 19:940

78 Montanaro D, Gropuzzo M, Tulissi P, et al Renoprotective effect of early inhibition of the

renin-angiotensin system in renal transplant recipients Transplant Proc 2005; 37:991

79 Heinze G, Mitterbauer C, Regele H, et al Angiotensin-converting enzyme inhibitor or angiotensin II

type 1 receptor antagonist therapy is associated with prolonged patient and graft survival after renal

transplantation J Am Soc Nephrol 2006; 17:889

80 Fabrizi F, Martin P, Dixit V, et al Hepatitis C virus antibody status and survival after renal

transplantation: meta-analysis of observational studies Am J Transplant 2005; 5:1452

81 Fabrizi F, Martin P, Dixit V, Messa P Meta-analysis of observational studies: hepatitis C and survival

after renal transplant J Viral Hepat 2014; 21:314

82 Rostami Z, Nourbala MH, Alavian SM, et al The impact of Hepatitis C virus infection on kidney

transplantation outcomes: A systematic review of 18 observational studies: The impact of HCV on

renal transplantation Hepat Mon 2011; 11:247

83 Pereira BJ, Natov SN, Bouthot BA, et al Effects of hepatitis C infection and renal transplantation on

survival in end-stage renal disease The New England Organ Bank Hepatitis C Study Group Kidney Int 1998; 53:1374

84 Knoll GA, Tankersley MR, Lee JY, et al The impact of renal transplantation on survival in hepatitis

C-positive end-stage renal disease patients Am J Kidney Dis 1997; 29:608

85 Maluf DG, Fisher RA, King AL, et al Hepatitis C virus infection and kidney transplantation: predictors

of patient and graft survival Transplantation 2007; 83:853

86 Ingsathit A, Kamanamool N, Thakkinstian A, Sumethkul V Survival advantage of kidney

4/2/2017 Hepatitis C infection in kidney transplant candidates and recipients

transplantation over dialysis in patients with hepatitis C: a systematic review and meta-analysis

Transplantation 2013; 95:943

87 Natov SN, Lau JY, Ruthazer R, et al Hepatitis C virus genotype does not affect patient survival among renal transplant candidates The New England Organ Bank Hepatitis C Study Group Kidney Int 1999;

56:700

88 Kanwal F, Kramer JR, Ilyas J, et al HCV genotype 3 is associated with an increased risk of cirrhosis

and hepatocellular cancer in a national sample of U.S Veterans with HCV Hepatology 2014; 60:98

89 Campos-Varela I, Lai JC, Verna EC, et al Hepatitis C genotype influences post-liver transplant

outcomes Transplantation 2015; 99:835