MÔ TẢ THỰC TRẠNG VIÊM GAN VI RÚT B,C TRÊN BỆNH NHÂN GHÉP THẬN TẠI BỆNH VIỆN BẠCH MAI

Abstract

Objectives: To describe characteristics of hepatitis B and C viruses, to evaluate kidney function and some related factors in hepatitis B and C patients after kidney transplant at Bach Mai hospital. Subjects and methods: Retrospective and prospective studies, description and analysis on all kidney transplant patients at Bach Mai hospital, comparision between non-hepatitis and hepatitis B and C groups. Results: Out of 223 kidney transplant patients at Bach Mai hospital, there were 24 patients with hepatitis B, 22 patients with hepatitis C, 1 patient with hepatitis B and C co-infection and 176 patients without viral hepatitis. The average number of years of grafting was 3.18± 1.77years. Regarding hepatitis B: prevalence, incidence and reactivation rate was 11.2%, 0.9% and 36%. No outbreak was detected. Regarding hepatitis C: prevalence, incidence and outbreak rate was 10.3%, 1.3% and 4.3%, respectively. Recurrence was not detected. In hepatitis B patients, mean ALT after transplantation up to 1 year; 3 years and from 5 years or more was 26.20± 14.80 UI/L; 32.20± 25.12 UI/L and 41.40± 20.80 UI/L, respectively. In hepatitis C, mean ALT after transplantation up to 1 year; 3 years and from 5 years or more was 27.61± 28.38 UI/L; 30.50± 20.11UI/L and 28.40± 9.66 UI/L, respectively. Mean blood creatinine in hepatitis B and C patients after transplantation up to 1 year; 3 years and from 5 years or more  was 103.89± 27.96 umol/l; 98.33± 22.13 umol/l and 100.90± 25.35 umol/l, respectively. The rates of proteinuria and erythrocytosis were similar at 29.8%. Conclusion: The prevalence of Hepatitis B and C in the kidney transplant population is equivalent to the rate of hepatitis B and C infection in the community. Hepatitis B reactivation rate is relatively high at 36%. Concentrations of liver enzymes in hepatitis B patients were higher than those in non-viral hepatitis patients. There was no difference in liver enzyme values between the non-viral hepatitis patients and hepatitis C patients. There was no difference in renal function between  non-viral hepatitis and hepatitis B and C patients at 5 years after transplantation. The rate of proteinuria and, erythrocytosis in 2 groups was not different.