Hepatitis C Virus Antibody Status and Survival After Renal Transplantation: Meta-Analysis of Observational Studies

Abstract

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 DerSimonian 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.