Seropositivity for anti-HCV core antigen is independently associated with increased all-cause, cardiovascular, and liver disease-related mortality in hemodialysis patients

• Published in: Journal of epidemiology Vol. 21; no. 6; pp. 491 - 499
• Main Authors: Ohsawa, Masaki, Kato, Karen, Tanno, Kozo, Itai, Kazuyoshi, Fujishima, Yosuke, Okayama, Akira, Turin, Tanvir Chowdhury, Onoda, Toshiyuki, Suzuki, Kazuyuki, Nakamura, Motoyuki, Kawamura, Kazuko, Akiba, Takashi, Sakata, Kiyomi, Fujioka, Tomoaki
• Format: Journal Article
• Language: English
• Published: Japan Japan Epidemiological Association 2011
• Subjects: Adult; Aged; Aged, 80 and over; Antigens; Cardiovascular disease; Cardiovascular Diseases - mortality; Cardiovascular Diseases - virology; Cause of Death; Clinical Epidemiology; Epidemiology; Female; Hemodialysis; Hepatitis; Hepatitis C - complications; Hepatitis C - immunology; Hepatitis C Antigens - blood; Humans; Japan - epidemiology; Liver Diseases - mortality; Liver Diseases - virology; Male; Middle Aged; Mortality; Original; Prospective Studies; Renal Dialysis - mortality; Risk Factors; Young Adult; Japan
• ISSN: 0917-5040; 1349-9092
• DOI: 10.2188/jea.je20100187

It is not known whether chronic or past hepatitis C virus (HCV) infection contributes to the high mortality rate in hemodialysis patients. This prospective study of 1077 adult hemodialysis patients without hepatitis B virus infection used Poisson regression analysis to estimate crude and sex- and age-adjusted rates (per 1000 patient-years) of all-cause, cardiovascular, infectious disease-related and liver disease-related mortality in patients negative for HCV antibody (group A), patients positive for HCV antibody and negative for anti-HCV core antigen (group B), and patients positive for anti-HCV core antigen (group C). The relative risks (RRs) for each cause of death in group B vs group C as compared with those in group A were also estimated by Poisson regression analysis after multivariate adjustment. A total of 407 patients died during the 5-year observation period. The sex- and age-adjusted mortality rate was 71.9 in group A, 80.4 in group B, and 156 in group C. The RRs (95% CI) for death in group B vs group C were 1.23 (0.72 to 2.12) vs 1.60 (1.13 to 2.28) for all-cause death, 0.75 (0.28 to 2.02) vs 1.64 (0.98 to 2.73) for cardiovascular death, 1.64 (0.65 to 4.15) vs 1.58 (0.81 to 3.07) for infectious disease-related death, and 15.3 (1.26 to 186) vs 28.8 (3.75 to 221) for liver disease-related death, respectively. Anti-HCV core antigen seropositivity independently contributes to elevated risks of all-cause and cause-specific death. Chronic HCV infection, but not past HCV infection, is a risk for death among hemodialysis patients.