title: Seropositivity for anti-HCV core antigen is independently associated with increased all-cause, cardiovascular, and liver disease-related mortality in hemodialysis patients.
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.
authors: Department of Hygiene and Preventive Medicine, Iwate Medical University, Iwate, Japan. masakio@iwate-med.ac.jp
authors: Masaki
authors: M
authors: Ohsawa
authors: Karen
authors: K
authors: Kato
authors: Kozo
authors: K
authors: Tanno
authors: Kazuyoshi
authors: K
authors: Itai
authors: Yosuke
authors: Y
authors: Fujishima
authors: Akira
authors: A
authors: Okayama
authors: Tanvir Chowdhury
authors: TC
authors: Turin
authors: Toshiyuki
authors: T
authors: Onoda
authors: Kazuyuki
authors: K
authors: Suzuki
authors: Motoyuki
authors: M
authors: Nakamura
authors: Kazuko
authors: K
authors: Kawamura
authors: Takashi
authors: T
authors: Akiba
authors: Kiyomi
authors: K
authors: Sakata
authors: Tomoaki
authors: T
authors: Fujioka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000821:virology; D002423:Cause of Death; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology; D018936:Hepatitis C Antigens / Q000097:blood*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008107:Liver Diseases / Q000401:mortality* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D018936:Hepatitis C Antigens