Differential effect of viral hepatitis infection on mortality among Korean maintenance dialysis patients: A prospective multicenter cohort study

Eugene Kwon, Jang Hee Cho, Hye Min Jang, Yon Su Kim, Shin Wook Kang, Chul Woo Yang, Nam Ho Kim, Hyun Ji Kim, Jeung Min Park, Ji Eun Lee, Hee Yeon Jung, Ji Young Choi, Sun Hee Park, Chan Duck Kim, Yong Lim Kim

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Article numbere0135476
JournalPloS one
Volume10
Issue number8
DOIs
Publication statusPublished - 2015 Aug 11

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viral hepatitis
Dialysis
Virus Diseases
dialysis
cohort studies
Viruses
Hepatitis C virus
Hepatitis
Multicenter Studies
Cohort Studies
Maintenance
Hepatitis C Antibodies
Mortality
Hepatitis B Surface Antigens
infection
Hepatitis B virus
Hepacivirus
antibodies
Hepatitis Viruses
Propensity Score

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Kwon, Eugene ; Cho, Jang Hee ; Jang, Hye Min ; Kim, Yon Su ; Kang, Shin Wook ; Yang, Chul Woo ; Kim, Nam Ho ; Kim, Hyun Ji ; Park, Jeung Min ; Lee, Ji Eun ; Jung, Hee Yeon ; Choi, Ji Young ; Park, Sun Hee ; Kim, Chan Duck ; Kim, Yong Lim. / Differential effect of viral hepatitis infection on mortality among Korean maintenance dialysis patients : A prospective multicenter cohort study. In: PloS one. 2015 ; Vol. 10, No. 8.
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title = "Differential effect of viral hepatitis infection on mortality among Korean maintenance dialysis patients: A prospective multicenter cohort study",
abstract = "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.",
author = "Eugene Kwon and Cho, {Jang Hee} and Jang, {Hye Min} and Kim, {Yon Su} and Kang, {Shin Wook} and Yang, {Chul Woo} and Kim, {Nam Ho} and Kim, {Hyun Ji} and Park, {Jeung Min} and Lee, {Ji Eun} and Jung, {Hee Yeon} and Choi, {Ji Young} and Park, {Sun Hee} and Kim, {Chan Duck} and Kim, {Yong Lim}",
year = "2015",
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Kwon, E, Cho, JH, Jang, HM, Kim, YS, Kang, SW, Yang, CW, Kim, NH, Kim, HJ, Park, JM, Lee, JE, Jung, HY, Choi, JY, Park, SH, Kim, CD & Kim, YL 2015, 'Differential effect of viral hepatitis infection on mortality among Korean maintenance dialysis patients: A prospective multicenter cohort study', PloS one, vol. 10, no. 8, e0135476. https://doi.org/10.1371/journal.pone.0135476

Differential effect of viral hepatitis infection on mortality among Korean maintenance dialysis patients : A prospective multicenter cohort study. / Kwon, Eugene; Cho, Jang Hee; Jang, Hye Min; Kim, Yon Su; Kang, Shin Wook; Yang, Chul Woo; Kim, Nam Ho; Kim, Hyun Ji; Park, Jeung Min; Lee, Ji Eun; Jung, Hee Yeon; Choi, Ji Young; Park, Sun Hee; Kim, Chan Duck; Kim, Yong Lim.

In: PloS one, Vol. 10, No. 8, e0135476, 11.08.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Differential effect of viral hepatitis infection on mortality among Korean maintenance dialysis patients

T2 - A prospective multicenter cohort study

AU - Kwon, Eugene

AU - Cho, Jang Hee

AU - Jang, Hye Min

AU - Kim, Yon Su

AU - Kang, Shin Wook

AU - Yang, Chul Woo

AU - Kim, Nam Ho

AU - Kim, Hyun Ji

AU - Park, Jeung Min

AU - Lee, Ji Eun

AU - Jung, Hee Yeon

AU - Choi, Ji Young

AU - Park, Sun Hee

AU - Kim, Chan Duck

AU - Kim, Yong Lim

PY - 2015/8/11

Y1 - 2015/8/11

N2 - 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.

AB - 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.

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