[Hepatitis virus infection in renal transplant recipients a prospective study]

[Article in Spanish]

Alvarez Chiva V, Carreño V, Plaza JJ, Mora I, Hernando L.

A high infection rate with hepatitis virus in renal transplant recipients has been demonstrated. However, the serological events that take place in the postransplant period have not been perfectly established, especially in relation to hepatitis B virus.

The aim of the present work is to determine the incidence of hepatic viral infection in the postransplant period, and the clinical and serological events in relation with hepatitis virus.

A total of 52 patients were included and followed prospectively. Of these, 18 had serological markers of HBV (Anti HBs + Anti HBc, Anti HBs, Anti HBc alone, HBsAg). During the follow up a decreases in titers of these antibodies was observed. However, in the postransplant period and increase of HBsAg concentration was demonstrated in patients with HBsAg + prior to the renal transplantation. In addition 10 patients suffered acute hepatitis, due to HBV (20%), cytomegalovirus (20%) and Non-A non-B virus (NANB, 60%). One of the cases of acute hepatitis B was diagnosed by the appearance of Anti HBc-IgM in the absence of HBsAg.

With respect to chronic evolution, 11 patients developed chronic hepatitis, NANB virus was the agent implicated in 10 cases, and HBV in the other case. This patient was also positive for HBV-DNAp.

In conclusion, during the postransplant period the HBV infection risk decreases as demostrated by titration of antibodies. However HBsAg concentration increases in these patients. The Anti-HBc IgM seems to be necessary to establish the diagnosis of HBV hepatitis in these patients. The principal agent responsable for hepatitis either acute or chronic in the transplant recipient is the NANB virus.