Differential Effect of Viral Hepatitis Infection on Mortality among Korean Maintenance Dialysis Patients: A Prospective Multicenter Cohort Study

Abstract

The role of infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) in terms of survival among dialysis patients remains incompletely understood. In the present multicenter prospective cohort study, we investigated the prevalences of HBV and HCV infection among 3,321 patients receiving maintenance dialysis in Korea, and assessed the impacts of these infections on survival. All included patients underwent hepatitis B antigen (HBsAg) and HCV antibody (Ab) testing, which revealed that 236 patients (7.1%) were HBsAg-positive, and 123 patients (3.7%) were HCV Ab-positive. HBsAg-positive and HCV Ab-positive patients were matched to hepatitis virus-negative patients using a propensity score at a ratio of 1:2. The prevalences of HBV and HCV infection did not significantly differ according to dialysis modality. Linear-by-linear association analysis revealed that hepatitis B prevalence significantly increased with increasing dialysis vintage (p = 0.001), and hepatitis C prevalence tended to be higher with increasing dialysis vintage (p = 0.074). We compared the survival of HBsAg-positive and HCV Ab-positive patients to that of hepatitis virus-negative patients. After propensity score matching, cumulative survival did not differ between HBsAg-positive and HBsAg-negative patients (p = 0.37), while HCV Ab-positive patients showed significantly lower survival than HCV Ab-negative patients (p = 0.03). The main conclusions of the present study are that HBV infection prevalence increased with longer dialysis vintage, and that both HBV and HCV infections were most prevalent among patients with the longest dialysis vintage. Additionally, HCV infection among maintenance dialysis patients is associated with an increased risk of mortality.

High Incidence of Hepatitis B Virus Infection in Hemodialysis Patients at Sanglah General Hospital and It’s Risk Factors

“…Based on the slightly higher prevalence of HBV infection among HD patients than the general population (2.5-10%) in Indonesia, there is a strong possibility that the prevalence of HBV infections among HD patients is caused by nosocomial infections. 23,24 Our study also showed that the HD duration and number of blood transfusions were signi cantly associated with HBV infection.…”

“…19 Studies from less developed countries estimated that the proportion of HBsAg carriers in the HD population varies from 2% to 20%. [20][21][22][23] A recent multicenter prospective cohort study among dialysis patients in Korea revealed that 7.1% were HBsAg-positive. 21 In Vietnam, 7% of HD patients tested positive for HBsAg.…”

Diagnostic Accuracy Study of Intraoperative and Perioperative Serum Intact PTH Level for Successful Parathyroidectomy in 501 Secondary Hyperparathyroidism Patients

“…Chronic hepatitis, which is mainly caused by hepatitis B virus (HBV) and hepatitis C virus (HCV), could be transmitted via infected blood products. Among patients receiving maintenance dialysis, the prevalence of HBV ranges from 1.3–14.6% and the prevalence of HCV is 0.7–18.1% 20 21 . To our knowledge, the influence of chronic hepatitis on intraoperative serum iPTH values in PTX patients has not been studied previously.…”

Daclatasvir and reduced‐dose sofosbuvir: An effective and pangenotypic treatment for hepatitis C in patients with estimated glomerular filtration rate <30 mL/min

“…All-cause mortality is known to be high among dialysis-dependent patients, especially if associated with HCV infection. 33,34 One of the renal transplant recipient patients developed acute mild pancreatitis, which was likely to have been drug-induced, though it is difficult to ascertain the exact drug because she was on two DAAs and three immunosuppressive medications at that time. Pancreatitis during the DAA-based treatment is very rare.…”