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目的：了解肾移植患者丙型肝炎病毒（ＨＣＶ）的感染情况及ＨＣＶ感染后的临床影响。方法：对６７例肾移植患者进行至少１年的随访，用第二代ＥＬＩＳＡ法和Ｎｅｓｔ－ＰＣＲ测定血清中抗ＨＣＶ和ＨＣＶＲＮＡ。结果：抗ＨＣＶ的阳性率５０．７％（３４例），ＨＣＶＲＮＡ的阳性率为４７．８％（３２例）。ＨＣＶＲＮＡ阳性组术前血透时间和输血量及丙氨酸转移酶（ＡＬＴ）水平明显高于ＨＣＶＲＮＡ阴性组，ＨＣＶＲＮＡ阳性组术前与术后ＡＬＴ水平差异不显著。术后ＨＣＶＲＮＡ阳性组的ＡＬＴ水平和肝脏损害的发病率明显高于ＨＣＶＲＮＡ阴性组，感染、排斥反应、移植物的存活率、肌酐水平在两组中差异不显著。结论：本研究显示，ＨＣＶ感染主要影响肾移植患者的肝脏病变，在短期内对患者的感染、排斥反应、移植物的存活率无显著影响，表明ＨＣＶ感染不是肾移植的禁忌证。
Objective: To understand the infection of hepatitis C virus (HCV) in patients after kidney transplantation and the clinical effect after HCV infection. METHODS: Sixty-seven patients with renal allograft were followed up for at least one year. Serum anti-HCV and HCV RNA were detected by second-generation ELISA and Nest-PCR. Results: The positive rate of anti-HCV was 50.7% (34 cases) and the positive rate of HCVRNA was 47.8% (32 cases). The preoperative hemodialysis time, blood transfusion, and alanine aminotransferase (ALT) levels in HCVRNA positive group were significantly higher than those in HCVRNA negative group. The preoperative and postoperative ALT levels in HCVRNA positive group were not significantly different. The postoperative incidence of ALT and liver damage in HCVRNA positive group was significantly higher than that in HCVRNA negative group. The infection, rejection, graft survival and creatinine were not significantly different between the two groups. CONCLUSIONS: This study shows that HCV infection mainly affects liver lesions in kidney transplant recipients and has no significant effect on patient infection, rejection and graft survival in a short period, suggesting that HCV infection is not a contraindication to renal transplantation.