title: Viral hepatitis and proteinuria in an area endemic for hepatitis B and C infections: another chain of link?
abstract: OBJECTIVE
  Virus hepatitis may lead to nephropathy as one of its multiple extrahepatic manifestations. Proteinuria by dipstick, a simple test in practice, is a useful and cardinal sign of underlying renal abnormalities. The aim of this study was to elucidate the impact of hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infections on the occurrence of proteinuria amongst adults.
  
  
  METHODS
  A prospective, cross-sectional, community-based study was conducted in an HBV/HCV endemic area of southern Taiwan. Eligible subjects aged 40-65 years (n=9934) underwent testing of hepatitis B surface antigen (HBsAg), HCV antibody (anti-HCV) and other related biochemical profiles. Urinalysis with repeated dipstick for proteinuria detection was performed.
  
  
  RESULTS
  Anti-HCV-positive rate amongst proteinuria subjects was significantly higher than nonproteinuria subjects (9.6% vs. 6.2%, P<0.001). By contrast, HBsAg-positive rate did not differ between subjects with and without proteinuria (13.0% vs. 13.8%, P=0.57). Prevalence of proteinuria amongst anti-HCV-positive subjects (10.2%) was significantly higher than that in HBsAg-positive subjects (6.4%, P=0.004) and in HBsAg-negative or anti-HCV-negative subjects (7.0%, P=0.004). The difference persisted even after excluding diabetics. Multivariate logistic regression analyses showed that diabetes was the most important significant factor associated with proteinuria, followed by hypertension, anti-HCV seropositivity, body mass index, age and triglyceride levels.
  
  
  CONCLUSIONS
  We demonstrated the significant association between proteinuria and HCV, but not HBV, infection in this HBV/HCV-endemic area.
authors.affiliation: Graduate Institute of Medicine, Kaohsiung Medical University, and Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan.
authors.forename: J-F
authors.initials: JF
authors.lastname: Huang
authors.forename: W-L
authors.initials: WL
authors.lastname: Chuang
authors.forename: C-Y
authors.initials: CY
authors.lastname: Dai
authors.forename: C-K
authors.initials: CK
authors.lastname: Ho
authors.forename: S-J
authors.initials: SJ
authors.lastname: Hwang
authors.forename: S-C
authors.initials: SC
authors.lastname: Chen
authors.forename: Z-Y
authors.initials: ZY
authors.lastname: Lin
authors.forename: L-Y
authors.initials: LY
authors.lastname: Wang
authors.forename: W-Y
authors.initials: WY
authors.lastname: Chang
authors.forename: M-L
authors.initials: ML
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D019353:Endemic Diseases; D004812:Epidemiologic Methods; D005260:Female; D016174:Hepacivirus; D006509:Hepatitis B / Q000652:urine*; D006515:Hepatitis B virus; D006526:Hepatitis C / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000652:urine* / Q000821:virology; D013624:Taiwan