Seropositivity for Anti-HCV Core Antigen is Independently Associated With Increased All-Cause, Cardiovascular, and Liver Disease-Related Mortality in Hemodialysis Patients

Masaki Ohsawa; Karen Kato; Kozo Tanno; Kazuyoshi Itai; Yosuke Fujishima; Akira Okayama; Tanvir Chowdhury Turin; Toshiyuki Onoda; Kazuyuki Suzuki; Motoyuki Nakamura; Kazuko Kawamura; Takashi Akiba; Kiyomi Sakata; Tomoaki Fujioka

doi:10.2188/jea.JE20100187

Original Article

Seropositivity for Anti-HCV Core Antigen is Independently Associated With Increased All-Cause, Cardiovascular, and Liver Disease-Related Mortality in Hemodialysis Patients

Masaki Ohsawa, Karen Kato, Kozo Tanno, Kazuyoshi Itai, Yosuke Fujishima, Akira Okayama, Tanvir Chowdhury Turin, Toshiyuki Onoda, Kazuyuki Suzuki, Motoyuki Nakamura, Kazuko Kawamura, Takashi Akiba, Kiyomi Sakata, Tomoaki Fujioka

Author information

Masaki Ohsawa
Department of Hygiene and Preventive Medicine, Iwate Medical University
Karen Kato
Division of Urology, San-ai Hospital
Kozo Tanno
Department of Hygiene and Preventive Medicine, Iwate Medical University
Kazuyoshi Itai
Department of Hygiene and Preventive Medicine, Iwate Medical University
Yosuke Fujishima
Department of Hygiene and Preventive Medicine, Iwate Medical University
Department of Urology, Iwate Medical University
Akira Okayama
The First Institute of Health Service, Japan Anti-Tuberculosis Association
Tanvir Chowdhury Turin
Department of Medicine, University of Calgary
Toshiyuki Onoda
Department of Hygiene and Preventive Medicine, Iwate Medical University
Kazuyuki Suzuki
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Iwate Medical University
Motoyuki Nakamura
Division of Cardiovascular Medicine, Nephrology and Endocrinology, Department of Internal Medicine, Iwate Medical University
Kazuko Kawamura
Iwate Health Service Association
Takashi Akiba
Division of Blood Purification, Kidney Center, Tokyo Women’s Medical University
Kiyomi Sakata
Department of Hygiene and Preventive Medicine, Iwate Medical University
Tomoaki Fujioka
Department of Urology, Iwate Medical University

Keywords: hepatitis C virus, hemodialysis, mortality, population-based cohort study

JOURNAL FREE ACCESS

2011 Volume 21 Issue 6 Pages 491-499

DOI https://doi.org/10.2188/jea.JE20100187

View "Advance Publication" version (October 15, 2011).

Details

Abstract

Background: It is not known whether chronic or past hepatitis C virus (HCV) infection contributes to the high mortality rate in hemodialysis patients.
Methods: 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.
Results: 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.
Conclusions: 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.

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