Eighteen‐year follow‐up cohort study on hepatitis B and C virus infections related long‐term prognosis among hemodialysis patients in Hiroshima

Abstract

This study aimed to investigate the prevalence trend of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections and their genotype distribution among hemodialysis patients, determining their long‐term prognosis and the risk factors to the mortality. This cohort study used both the medical data and the blood samples of hemodialysis patients at nine dialysis centers in Hiroshima from 1999 to 2017. Hepatitis B surface antigen (HBsAg) and anti‐HCV were screened and then amplification was done to positive sera by polymerase chain reaction for genotyping. Data were employed for multiple regressions to determine the associated risk factors. A total of 3968 patients were subdivided into three groups: who started hemodialysis before 1990, during 1991 to 2001, and after 2002. The periodic prevalence of HBsAg decreased from 2.8% to 1.3% and that of anti‐HCV from 33.3% to 9.5% in the three groups. By multiple regressions, the adjusted hazard ratio of diabetes mellitus (DM) ranges from 1.59 to 2.12 and that of HCV RNA positivity ranges from 1.18 to 1.48 (P < .05). Heart failure is the primary cause of death in all groups. Genotype C2 is predominant for HBV and genotype 1b is predominant for HCV. The decreasing trend of both HBV and HCV was found in the cohort. DM and HCV RNA were the significant risk factors leading to poor prognosis among hemodialysis patients. The similar genotype distribution of both HBV and HCV was found as general population. This alarmed to provide early diagnosis, prompt, and adequate treatment to HCV infection among hemodialysis patients.

Epidemiology of viral hepatitis C: Road to elimination in Japan

“…At times, HCV genotype 2b comes across over genotype 1b among those born after 1970 while genotype 2a is constantly found in all age groups in Japan (8,9,11). A similar pattern of genotype distribution was also found in hemodialysis patients and a change in genotype distribution from genotype 1b to 2a/2b was also reported among those who started dialysis after 1991 (12). In this review article, we would like to express the epidemiology of HCV in Japan.…”

“…The annual incidence of HCV infection was 0.33% i.e., 3 in 1,000 hemodialysis patients were newly infected with HCV infection in a year. A recent study showed that the decreasing trend of both anti-HCV and HCV RNA positivity was found by their dialysis started year (12). For those who started dialysis after 2002, anti-HCV prevalence was 9.5% and HCV RNA positivity was 7%.…”

Circulation of an atypical hepatitis C virus (HCV) strain at a dialysis unit in northeast India

“…The genotype distribution patterns in such cases usually reflect the distribution in the general population (Ko et al, 2020).…”

“…Reports on other HCV 3 subtypes causing chronic hepatitis or dialysis‐related infections exist; however, HCV 3f‐related outbreaks could not be retrieved from published literature. Multiple reports on the dialysis‐related transmission of HCV genotypes such as 1b, 1a, and 3a, exist (Hmaied et al, 2006; Izopet et al, 1999; Ko et al, 2020). Recently, a Pune (India)‐based study reported an HCV outbreak in a dialysis unit, where 84.6% of the isolates belonged to HCV 1b with 99.3% nucleotide sequence similarity, indicating a nosocomial transmission (Roy et al, 2019).…”

“…The genotype distribution patterns in such cases usually reflect the distribution in the general population (Ko et al, 2020). A multicenter study reported an HCV infection rate of 69% in eastern India (including our region), which was caused by genotype 3, without any subtyping data (Shah et al, 2016).…”