Hepatitis B may show a more aggressive course after kidney transplantation.
However, the factors associated with the progression of fibrosis in this group have not been identified.
Dr Carla Matos and colleagues determined the influence of Hepatitis B virus viral load and host-related factors on the progression of hepatic fibrosis in Hepatitis B virus-infected renal transplant recipients.
|31% of patients had advanced fibrosis|
|European Journal of Gastroenterology & Hepatology|
Renal transplant patients positive for Hepatitis B virus surface antigen and submitted to liver biopsy because of evidence of viral replication were included.
Patients with advanced fibrosis were compared with patients with mild fibrosis regarding sex, age.
The researchers identified 55 patients, of which 75% were men with a mean post-transplant time of 5 years.
The team evaluated estimated time since infection, post-transplant time, donor type, history of renal transplantation, and alanine aminotransferase.
Anti-hepatitis C virus, Hepatitis B e antigen and quantitative Hepatitis B virus-DNA were also assessed.
Logistic regression analysis was applied to identify variables independently associated with more advanced fibrosis.
The researchers detected Hepatitis B e antigen in 67% of the patients and anti-Hepatitis C virus in 35%.
The team noted that the median Hepatitis B virus-DNA level was 2.8x108 copies/ml.
The research team observed that 31% of patients had advanced fibrosis.
Using logistic regression analysis, the only variable that showed an independent association with more advanced stages of fibrosis was post-transplant time.
Dr Matos' team concluded, "Hepatitis B virus viral load, although very high, and Hepatitis B virus/Hepatitis C virus coinfection are not related to the intensity of liver fibrosis in renal transplant patients infected with Hepatitis B virus."
"Post-transplant time was the only factor independently associated with more advanced liver fibrosis, suggesting the influence of immunosuppression on the progression of liver disease in these patients."