title: Patterns in the prevalence of hepatitis C virus infection at the start of hemodialysis in Japan.
abstract: BACKGROUND
  Although hepatitis C virus (HCV) infection is a persistent public health concern in hemodialysis patients, there seem to have been only a few reports on the prevalence of HCV at the start of hemodialysis. In this study we investigated whether patients starting on hemodialysis therapy are positive for anti-HCV antibody or not.
  
  
  METHODS
  The 400 patients who began regular hemodialysis between February 2003 and June 2007 were enrolled in this study. Clinical data such as age, anti-HCV antibody and primary cause of end-stage kidney disease (ESKD) were examined. As healthy controls we used 70,717 healthy blood donors in 2005 whose data were obtained from Tokyo Metropolitan Red Cross Blood Center. Anti-HCV antibody was used as an indicator of HCV infection. Since the prevalence of HCV infection is affected by age in Japan, we classified the patients by age group.
  
  
  RESULTS
  The anti-HCV antibody prevalence rate among the patients who were new to hemodialysis was 7.3%, as opposed to 0.15% in the healthy volunteers. The prevalence of HCV in the 31-45-, 46-60-, and 61-year-old groups was significantly higher among the hemodialysis patients than among the healthy volunteers (P = 0.0209, <0.0001, and <0.0001, respectively). The prevalence rate of anti-HCV antibody was higher among men (10.0%) than among women (1.5%, P < 0.0001) in the hemodialysis patients. The anti-HCV-antibody-positive patients were significantly older than the anti-HCV-antibody-negative patients (66.4 +/- 14.3 years versus 58.6+/-16.6 years; P = 0.0152). Diabetic nephropathy was a more frequent cause of ESKD among the anti-HCV-antibody-positive patients (30.4%) than among the anti-HCV-antibody-negative patients (19.9%, P = 0.0122). Among the anti-HCV-antibody-positive patients, 55.2% had received a blood transfusion. The rate was significantly higher than that among the anti-HCV-antibody-negative patients (19.4%, P < 0.0001).
  
  
  CONCLUSIONS
  The results showed a much higher rate of anti-HCV antibody positivity in patients new to hemodialysis than in healthy volunteers. Older age, blood transfusion, male gender, and diabetic nephropathy seemed to be risk factors for anti-HCV antibody positivity in Japan.
authors.affiliation: Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Iwasa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Otsubo
authors.forename: Orie
authors.initials: O
authors.lastname: Sugi
authors.forename: Keitaro
authors.initials: K
authors.lastname: Sato
authors.forename: Yukari
authors.initials: Y
authors.lastname: Asamiya
authors.forename: Aya
authors.initials: A
authors.lastname: Eguchi
authors.forename: Tomihito
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Nami
authors.initials: N
authors.lastname: Matsuda
authors.forename: Kan
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Norisato
authors.initials: N
authors.lastname: Ikebe
authors.forename: Naoko
authors.initials: N
authors.lastname: Miwa
authors.forename: Naoki
authors.initials: N
authors.lastname: Kimata
authors.forename: Keiko
authors.initials: K
authors.lastname: Uchida
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Uchida
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
authors.forename: Takashi
authors.initials: T
authors.lastname: Akiba
mesh_terms: D000328:Adult; D000368:Aged; D001782:Blood Donors / Q000706:statistics & numerical data; D003928:Diabetic Nephropathies / Q000821:virology; D005260:Female; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis
chemical_list: D018937:Hepatitis C Antibodies