[Elevated cyclosporine A trough levels in HCV positive kidney transplant recipients]. / Níveis de vale de ciclosporina elevados em transplantados renais anti-HCV positivos.

ABSTRACT

OBJECTIVE: Compare the CsA trough levels of HCV+ kidney transplant recipients to a control group METHODS: All anti-HCV positive patients that received a renal allograft between January 1992 and April 1996 were initially included as cases. Patients with diabetes mellitus, HBsAg+, who were taking medication that could modify CsA pharmacokinetics and those with elevated aminotransferases were excluded. For each anti-HCV positive index case the following transplanted anti-HCV negative patient was included as a control. Third generation ELISA was used for determination of the anti-HCV status and CsA dosages were performed by polarized fluorometry with polyclonal antibodies. RESULTS: No differences in the demographic variables were found. The average CsA through levels in the first month were higher (551 +/- 280 ng/ml) in the 23 cases as compared to the 31 controls (418 +/- 228 ng/ml; p< 0.05). The differences became apparent at the end of the first week (528 +/- 275 versus 344 +/- 283 ng/ml; p<0.01) and persisted at discharge (582 +/-284 versus 457 +/- 229; p=0,08). CONCLUSION: We concluded that anti-HCV positive patients have higher blood levels of CsA for a particular dosage, than anti-HCV negative controls. Prospective studies with a more appropriate pharmacokinetic approach are needed to confirm the present findings.