Impact of Hepatitis C Virus Infection on the Risk of Infectious Complications After Kidney Transplantation: Data From the RESITRA/REIPI Cohort

Background. There is scarce information regarding the role of hepatitis C virus (HCV) infection in the development of infectious complications after kidney transplantation (KT). Methods. We prospectively analyzed all KT recipients included in the Spanish Network for the Research of Infection in Transplantation cohort from September 2003 to February 2005 with a posttransplant follow-up of 3 years and compared the incidence of both overall and specific infections according to the pretransplant anti-HCV antibody status. Results. Of 1302 analyzed recipients, 105 (8.1%) were anti-HCV positive. These patients presented a higher rate of previous transplant (P<0.001), had a lower donor age (P=0.055), higher transfusion requirements (P=0.037), and more frequently received induction therapy with antithymocyte antibodies (P=0.005). We found no differences between anti-HCV-positive and -negative recipients in the overall incidence rate of infection (0.82 vs. 0.74 episodes per 1000 transplant-days, respectively). Nevertheless, anti-HCV-positive recipients had a higher cumulative incidence of bloodstream (P=0.01) and upper urinary tract infections (P=0.037). Anti-HCV status emerged by logistic regression as an independent risk factor only for bloodstream infection (odds ratio, 3.14; 95% confidence interval, 1.19-8.24; P=0.020). Anti-HCV-positive recipients also experimented a higher rate of recurrent acute rejection (P=0.045) and retransplantation (P=0.017), with no differences in overall mortality. Conclusions. According to the results of the Spanish Network for the Research of Infection in Transplantation cohort, the incidence of some potentially severe posttransplant infections may be increased in anti-HCV-positive KT recipients.