Differential Effect of Viral Hepatitis Infection on Mortality among Korean Maintenance Dialysis Patients: A Prospective Multicenter Cohort Study.
The role of infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) in terms of survival among dialysis patients remains incompletely understood. In the present multicenter prospective cohort study, we investigated the prevalences of HBV and HCV infection among 3,321 patients receiving maintenance dialysis in Korea, and assessed the impacts of these infections on survival. All included patients underwent hepatitis B antigen (HBsAg) and HCV antibody (Ab) testing, which revealed that 236 patients (7.1%) were HBsAg-positive, and 123 patients (3.7%) were HCV Ab-positive. HBsAg-positive and HCV Ab-positive patients were matched to hepatitis virus-negative patients using a propensity score at a ratio of 1:2. The prevalences of HBV and HCV infection did not significantly differ according to dialysis modality. Linear-by-linear association analysis revealed that hepatitis B prevalence significantly increased with increasing dialysis vintage (p = 0.001), and hepatitis C prevalence tended to be higher with increasing dialysis vintage (p = 0.074). We compared the survival of HBsAg-positive and HCV Ab-positive patients to that of hepatitis virus-negative patients. After propensity score matching, cumulative survival did not differ between HBsAg-positive and HBsAg-negative patients (p = 0.37), while HCV Ab-positive patients showed significantly lower survival than HCV Ab-negative patients (p = 0.03). The main conclusions of the present study are that HBV infection prevalence increased with longer dialysis vintage, and that both HBV and HCV infections were most prevalent among patients with the longest dialysis vintage. Additionally, HCV infection among maintenance dialysis patients is associated with an increased risk of mortality.
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Eugene
E
Kwon
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Jang-Hee
JH
Cho
Department of Statistics, Kyungpook National University, Daegu, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Hye Min
HM
Jang
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Yon Su
YS
Kim
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Shin-Wook
SW
Kang
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Chul Woo
CW
Yang
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Nam-Ho
NH
Kim
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Hyun-Ji
HJ
Kim
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Jeung-Min
JM
Park
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Ji-Eun
JE
Lee
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Hee-Yeon
HY
Jung
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Ji-Young
JY
Choi
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Sun-Hee
SH
Park
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea; Clinical Research Center for End Stage Renal Disease in Korea.
Chan-Duck
CD
Kim
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea; Clinical Research Center for End Stage Renal Disease in Korea; BK21Plus KNU Biomedical Convergence Program, Department of Biomedical Science, Kyungpook National University, Daegu, Korea.
Yong-Lim
YL
Kim
D000328:Adult; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000401:mortality; D006526:Hepatitis C / Q000150:complications / Q000401:mortality; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D056910:Republic of Korea