Abstract:

BACKGROUND: The selection of immunosuppressants and anti-hepatitis C virus drug is currently the focus for the hepatitis C virus-positive patients after receiving renal transplantation.
OBJECTIVE: To investigate the anti-virus replication effect of cyclosporine in hepatitis C virus-RNA positive renal transplant recipients in addition to its anti-rejection effect.
METHODS: Eleven hepatitis C virus-RNA positive renal transplant recipients were enrolled and treated with cyclosporine, prednisone and mizoribine. Hepatitis C virus-RNA level, hemoglobin, liver functions and renal functions were evaluated before treatment and at 6 and 12 months after treatment.
RESULTS AND CONCLUSION: The median of hepatitis C virus-RNA in 11 patients before treatment, and at 6 and 12 months after treatment were 1.22×10⁷ copies/mL, 1.11×10⁴ copies/mL and 4.19×10⁶ copies/mL respectively. At 6 months after treatment, 8 cases of hepatitis C virus-RNA were negative (hepatitis C virus-RNA < 500 copies/mL), and the total response of hepatitis C virus-RNA was 73%, and the sustained virological response was 55% (6/11) at the final follow-up. There was no significant difference of alanine transaminase, serum creatinine and serum uric acid levels before and after treatment (P > 0.05), and the hemoglobin level was increased after treatment. During the follow-up, acute rejection only occurred in one patient and was controlled within 3 days after methylprednisolone pulse therapy. Cyclosporine-based treatment would be a better choice for renal transplant recipients combined with hepatitis C virus infection for both the anti-virus replication and anti-rejection effect.