TY - JOUR
T1 - Hepatitis C virus antibody status and survival after renal transplantation
T2 - Meta-analysis of observational studies
AU - Fabrizi, Fabrizio
AU - Martin, Paul
AU - Dixit, Vivek
AU - Bunnapradist, Suphamai
AU - Dulai, Gareth
PY - 2005/6
Y1 - 2005/6
N2 - The natural history of hepatitis C virus (HCV) among patients after renal transplantation (RT) remains incompletely defined. We conducted a systematic review of the published medical literature on the impact of hepatitis C antibody status on survival of patients who received RT. We used the random effects model of Der-Simonian and Laird to generate a summary estimate of the relative risk (RR) for mortality and graft loss with HCV seropositivity across the published studies. We identified eight clinical trials (6365 unique patients); six (75%) were cohort studies and two (2/8 = 25%) controlled trials, respectively. Pooling of study results demonstrated that presence of anti-HCV antibody was an independent and significant risk factor for death and graft failure after RT; the summary estimate for RR was 1.79 (95% CI, 1.57-2.03; homogeneity test, p = 0.0427) and 1.56 (95% CI, 1.35-1.80; homogeneity test, p = 0.0192), respectively. As a cause of death, hepatocellular carcinoma (HCC) and liver cirrhosis were significantly more frequent among anti-HCV positive than anti-HCV negative RT patients. This meta-analysis demonstrates that RT recipients with anti-HCV antibody have an increased risk of mortality and graft failure compared with HCV antibody negative patients.
AB - The natural history of hepatitis C virus (HCV) among patients after renal transplantation (RT) remains incompletely defined. We conducted a systematic review of the published medical literature on the impact of hepatitis C antibody status on survival of patients who received RT. We used the random effects model of Der-Simonian and Laird to generate a summary estimate of the relative risk (RR) for mortality and graft loss with HCV seropositivity across the published studies. We identified eight clinical trials (6365 unique patients); six (75%) were cohort studies and two (2/8 = 25%) controlled trials, respectively. Pooling of study results demonstrated that presence of anti-HCV antibody was an independent and significant risk factor for death and graft failure after RT; the summary estimate for RR was 1.79 (95% CI, 1.57-2.03; homogeneity test, p = 0.0427) and 1.56 (95% CI, 1.35-1.80; homogeneity test, p = 0.0192), respectively. As a cause of death, hepatocellular carcinoma (HCC) and liver cirrhosis were significantly more frequent among anti-HCV positive than anti-HCV negative RT patients. This meta-analysis demonstrates that RT recipients with anti-HCV antibody have an increased risk of mortality and graft failure compared with HCV antibody negative patients.
KW - Anti-HCV antibody
KW - Hepatitis C virus
KW - Meta-analysis
KW - Mortality
KW - Renal transplantation
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=20544463615&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=20544463615&partnerID=8YFLogxK
U2 - 10.1111/j.1600-6143.2005.00864.x
DO - 10.1111/j.1600-6143.2005.00864.x
M3 - Article
C2 - 15888054
AN - SCOPUS:20544463615
VL - 5
SP - 1452
EP - 1461
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 6
ER -