Effect of Anti-HCV Positivity on Markers of Malnutrition and Inflammation in Hemodialysis Patients

Abstract

Aim. To investigate the influence of anti-HCV positivity on markers of malnutrition and inflammation in hemodialysis (HD) patients. Methods. Stable HD patients who had persistently negative or positive HCV antibodies (at least three) and without elevated aminotransferase levels in routine periodical tests with a duration of more than 12 months were included. Patients with conditions known to be associated with acute-phase responses or clinically active (HCV RNA positive) or advanced liver failure were excluded. Thirty-six anti-HCV-positive patients (22 male, 14 female, mean age 47.3 ± 14.5 years, mean time on HD 72.0 ± 39.0 months), were compared with 36 anti-HCV negative patients with similar age and HD duration (25 male, 11 female, mean age 49.2 ± 13.8 years, mean time on HD 59.7 ± 27.1 months). Malnutrition-Inflammation Score (MIS), a fully quantitative score adopted from subjective global assessment, was recorded for each patient (ranges from 0 to 30). High sensitivity serum C-reactive protein (hs-CRP), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), and hematocritcorrected ESR were compared as indices of the degree of inflammation beyond anthropometric evaluation and routine laboratory tests.Results. There was no significant difference in MIS of two groups (6.1 ± 3.2 vs. 5.6 ± 3.2, p > 0.05). In the comparison of components of MIS, co-morbidity including number of years on dialysis was higher in anti-HCV-positive patients (p = 0.04). Anthropometric values and serum levels of hs-CRP, IL-6, ESR, and hematocrit-corrected ESR of two groups were not statistically different from each other (p > 0.05 for all). ALT (p = 0.0001) and AST (p = 0.001) levels were higher in anti-HCV-positive patients. Conclusion. Anti-HCV positivity without active infection seems to have no additional negative effect on malnutrition and inflammation in maintenance HD patients.

An Assay: Hepatitis C Doesn磘 Incite Increased C-Reactive Protein Level in Hemodialysis Patients Unless Another Inflammatory Condition is Associated

“…Iancu et al determined that 77.5% HD patients were anti-HCV reagents but only 12.19% had elevated CRP levels [4] . Zumrudtal et al, comparing anti-HCV (+) with anti-HCV (-) individuals, regarding some acute inflammatory markers, verified that these parameters were not different between the groups [5] . On the other hand, it was shown that HCV (+) patients have more severe signs of malnutrition-inflammation complex syndrome than HCV non-reagent individuals [6] .…”

Complete blood count, measures of iron status and inflammatory markers in inner-city African Americans with undiagnosed hepatitis C seropositivity

“…Some investigators have reported that HCV infection is associated with increased expression of interleukin-6 [23–26], while others have not observed increased expression [27,28]. One study indicated that the interleukin-6 response to stimulation of toll like receptors 3 and 4 is compromised in HCV infection [29].…”

Nutritional Status of Hemodialysis Patients with Hepatitis C Infection

“…[1] It is not at all surprising that they did not find any differences in markers of inflammations and nutritional status in their study. This is because they had excluded patients with active disease (positive for HCV RNA) and advanced liver disease.…”