Hepatitis C infection and renal cell carcinoma:A systematic review and meta-analysis

AIM To investigate the association between hepatitis C virus(HCV) infection and risk of renal cell carcinoma(RCC).METHODS A literature search was performed from inception until February 2016.Studies that reported relative risks,odd ratios,hazard ratios or standardized incidence ratio comparing the risk of RCC among HCV-infected participants vs those without HCV infection were included.Participants without HCV infection were used as comparators.Pooled odds ratios and 95%CI were calculated using a random-effect,generic inverse variance method.RESULTS Seven observational studies were with 196826 patients were included in the analysis to assess the risk of RCC in patients with HCV.A significantly increased risk of RCC among participants with HCV infection was found with a pooled RR of 1.86(95%CI:1.11-3.11).The association between RCC and HCV was marginally insignificant after a sensitivity analysis limited only to studies with adjusted analysis,with a pooled RR of 1.50(95%CI:0.93-2.42).CONCLUSION Our study demonstrated a potential association between HCV infection and RCC.Further studies of RCC surveillance in patients with HCV are required.     

Cytomegalovirus mismatch still negatively affects patient and graft survival in the era of routine prophylactic and preemptive therapy: A paired kidney analysis

The impact of cytomegalovirus (CMV) serostatus on kidney transplant outcomes in an era when CMV prophylactic and preemptive strategies are used routinely is not clearly established. Using United Network for Organ Sharing/Organ Procurement and Transplantation Network data, recipients with first deceased donor kidney transplant (≥18 years, 2010‐2015) were stratified into 4 groups in the main cohort: CMV‐seronegative donor (D?)/CMV‐seronegative recipient (R?), CMV‐seropositive donor (D+)/R?, D+/CMV‐seropositive recipient (R+), and D?/R+. In a paired kidney cohort, we identified 2899 pairs of D? kidney transplant with discordance of recipient serostatus (D?/R? vs D?/R+) and 4567 pairs of D+ kidney transplant with discordance of recipient serostatus (D+/R? vs D+/R+). In the main cohort, D+/R? was associated with a higher risk of graft failure (hazard ratio [HR] = 1.17, P = .01), all‐cause mortality (HR = 1.18, P < .001), and infection‐related mortality (HR = 1.38, P = .03) compared with D?/R?. In the paired kidney analysis, D+/R? was an independent risk factor for all‐cause mortality (HR = 1.21, P = .003) and infection‐related mortality (HR = 1.47, P = .04) compared with D+/R+. No difference in graft loss between D+/R? and D+/R+. CMV mismatch is still an independent risk factor for graft loss and patient mortality. The negative impact of D+/R? serostatus on mortality persists after fully matching for donor factors.