Volume 11, Issue 5 pp. 370-378

ORIGINAL ARTICLE

Effects of preoperative hepatitis B virus infection, hepatitis C virus infection, and coinfection on the development of new-onset diabetes after kidney transplantation

肾移植术前乙肝病毒感染、丙肝病毒感染及其共感染对移植后新发糖尿病发病的影响

Jing Liang,

Jing Liang

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

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Chaoyang Lv,

Chaoyang Lv

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

Department of Geriatric Endocrinology, Zhengzhou Seventh People's Hospital, Zhengzhou, China

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Minling Chen,

Minling Chen

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

Departments of Endocrinology and Metabolism, People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine (The People's Hospital of Fujian Province), Fuzhou, China

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Ming Xu,

Ming Xu

Department of Urology, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, Shanghai, China

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Chenhe Zhao,

Chenhe Zhao

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

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Yinqiu Yang,

Yinqiu Yang

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

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Jina Wang,

Jina Wang

Department of Urology, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, Shanghai, China

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Dong Zhu,

Dong Zhu

Department of Urology, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, Shanghai, China

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Jian Gao,

Jian Gao

Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai, China

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Ruiming Rong,

Corresponding Author

Ruiming Rong

[email protected]

Department of Urology, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, Shanghai, China

Department of Transfusion, Zhongshan Hospital, Fudan University, Shanghai, China

Correspondence

Mingxiang Yu, Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China.

Email: [email protected]

Ruiming Rong, Department of Urology, Department of Transfusion, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, 180 Fenglin Road, Shanghai 200032, China.

Email: [email protected]

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Tongyu Zhu,

Tongyu Zhu

Department of Urology, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, Shanghai, China

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Mingxiang Yu,

Corresponding Author

Mingxiang Yu

[email protected]

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

Correspondence

Mingxiang Yu, Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China.

Email: [email protected]

Ruiming Rong, Department of Urology, Department of Transfusion, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, 180 Fenglin Road, Shanghai 200032, China.

Email: [email protected]

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Jing Liang,

Jing Liang

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

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Chaoyang Lv,

Chaoyang Lv

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

Department of Geriatric Endocrinology, Zhengzhou Seventh People's Hospital, Zhengzhou, China

Search for more papers by this author

Minling Chen,

Minling Chen

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

Departments of Endocrinology and Metabolism, People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine (The People's Hospital of Fujian Province), Fuzhou, China

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Ming Xu,

Ming Xu

Department of Urology, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, Shanghai, China

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Chenhe Zhao,

Chenhe Zhao

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

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Yinqiu Yang,

Yinqiu Yang

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

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Jina Wang,

Jina Wang

Department of Urology, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, Shanghai, China

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Dong Zhu,

Dong Zhu

Department of Urology, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, Shanghai, China

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Jian Gao,

Jian Gao

Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai, China

Search for more papers by this author

Ruiming Rong,

Corresponding Author

Ruiming Rong

[email protected]

Department of Urology, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, Shanghai, China

Department of Transfusion, Zhongshan Hospital, Fudan University, Shanghai, China

Correspondence

Mingxiang Yu, Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China.

Email: [email protected]

Ruiming Rong, Department of Urology, Department of Transfusion, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, 180 Fenglin Road, Shanghai 200032, China.

Email: [email protected]

Search for more papers by this author

Tongyu Zhu,

Tongyu Zhu

Department of Urology, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, Shanghai, China

Search for more papers by this author

Mingxiang Yu,

Corresponding Author

Mingxiang Yu

[email protected]

Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China

Correspondence

Mingxiang Yu, Departments of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China.

Email: [email protected]

Ruiming Rong, Department of Urology, Department of Transfusion, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory of Organ Transplantation, 180 Fenglin Road, Shanghai 200032, China.

Email: [email protected]

Search for more papers by this author

First published: 11 September 2018

https://doi.org/10.1111/1753-0407.12853

Citations: 6

Funding information The study was supported by the China Health Promotion Foundation and the National Natural Science Foundation of China (Grant number: 81770747).

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Abstract

Background

The effects of preoperative hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, and HBV plus HCV coinfection on the development of new-onset diabetes after transplantation (NODAT) remain unexplored in kidney transplant recipients (KTRs). This study examined the association between preoperative viral status (i.e., HBV, HCV, and HBC + HCV infection) and incident NODAT in a large population of Chinese KTRs.

Methods

This population-based retrospective cohort study enrolled 557 subjects who underwent kidney transplantation between 1993 and 2014 at Zhongshan Hospital. Pre-, peri-, and postoperative data were extracted and analyzed. Viral status was defined by serological results for hepatitis B surface antigen and anti-HCV antibody. The cumulative incidence of NODAT was compared across four groups of KTRs with different viral status. Multivariate Cox regression models were used to estimate the effects of HBV, HCV, and HBC + HCV infection on incident NODAT after adjusting for important confounders.

Results

Patients seropositive for HCV (both HCV monoinfection and HBC + HCV coinfection) had a significantly higher cumulative incidence of NODAT than KTRs who were not infected with HCV (P < 0.05 for both). However, only HCV infection alone was found to be a risk factor for NODAT, increasing the NODAT risk 3.03-fold (95% confidence interval 1.77-5.18; P < 0.001). There was no independent correlation between HBV infection (alone or combined with HCV) and incident NODAT in KTRs.

Conclusions

Preoperative HCV infection significantly increased the risk of NODAT in Chinese KTRs, whereas HBV infection and HBC + HCV coinfection were not correlated with NODAT development.

Abstract

摘要

背景

在肾移植受者中，术前乙肝病毒(hepatitis B virus，HBV)感染、丙肝病毒(hepatitis C virus，HCV)感染及其共感染对其移植术后新发糖尿病(new-onset diabetes after transplantation，NODAT)发病的影响还未完全阐明。因此，本研究的目的在于探索中国肾移植受者人群中，术前病毒感染情况(即HBV感染、HCV感染以及HBV+HCV共感染)与术后NODAT发生情况之间的关系。

方法

本研究为回顾性队列研究，纳入的研究对象为1993年至2014年在中山医院接受同种异体肾移植术的557例肾移植受者，并收集其术前、围术期及术后资料进行分析。病毒感染情况按照其术前乙肝病毒表面抗原及抗丙肝病毒抗体的血清学检测结果来定义，并据此将入组患者分为4组(HBV单独感染组、HCV单独感染组、共感染组以及未感染肝炎病毒组)。首先，组间比较其NODAT累计发病率；接着，使用多因素COX回归分析逐步校正混杂因素，分别探索HBV感染、HCV感染以及共感染对NODAT发病的独立影响。

结果

与未感染HCV的患者(包括HBV单独感染组和未感染组)相比，感染HCV的患者(包括HCV单独感染组和共感染组)中NODAT累计发病率显著升高(P值均< 0.05)。进一步校正混杂因素后，发现只有术前HCV感染独立增加NODAT发病风险3.03倍，(95%置信区间 1.77-5.18，P < 0.001)；而术前HBV感染，不论是否同时合并HCV感染，均不独立影响NODAT发病风险。

结论

中国肾移植受者人群中，术前HCV感染是发生NODAT的独立危险因素；未发现术前HBV感染或HBV+HCV共感染与NODAT发病存在显著关联。

Supporting Information

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Citing Literature

Volume11, Issue5

May 2019

Pages 370-378

This article also appears in:

Filename	Description
jdb12853-sup-0001-FigureS1.tifPDF document, 548.5 KB	Figure S1. Incidence of new-onset diabetes after transplantation according to maintenance drug and serological results for anti-hepatitis C virus (HCV) antibody. FK506, tacrolimus; CsA, cyclosporin A.
jdb12853-sup-0002-TableS1.docWord document, 16 KB	Table S1. Results of Chi-squared tests in the hepatitis C virus-positive group.
jdb12853-sup-0003-TableS2.docWord document, 17 KB	Table S2. Multivariate Cox regression analysis of the association between hepatitis C virus infection and incident new-onset diabetes after transplantation, stratified by type of immunosuppressant.

Effects of preoperative hepatitis B virus infection, hepatitis C virus infection, and coinfection on the development of new-onset diabetes after kidney transplantation

肾移植术前乙肝病毒感染、丙肝病毒感染及其共感染对移植后新发糖尿病发病的影响

Abstract

Background

Methods

Results

Conclusions

Abstract

摘要

背景

方法

结果

结论

Supporting Information

REFERENCES

Citing Literature

References

Information

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Effects of preoperative hepatitis B virus infection, hepatitis C virus infection, and coinfection on the development of new-onset diabetes after kidney transplantation

肾移植术前乙肝病毒感染、丙肝病毒感染及其共感染对移植后新发糖尿病发病的影响

Abstract

Background

Methods

Results

Conclusions

Abstract

摘要

背景

方法

结果

结论

Supporting Information

REFERENCES

Citing Literature

References

Related

Information