Viral hepatitis and proteinuria in an area endemic for hepatitis B and C infections: another chain of link?
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.
Huang
J-F
JF
Graduate Institute of Medicine, Kaohsiung Medical University, and Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan.
Chuang
W-L
WL
Dai
C-Y
CY
Ho
C-K
CK
Hwang
S-J
SJ
Chen
S-C
SC
Lin
Z-Y
ZY
Wang
L-Y
LY
Chang
W-Y
WY
Yu
M-L
ML
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