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

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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

All Science Journal Classification (ASJC) codes

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

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    Kwon, E., Cho, J. H., Jang, H. M., Kim, Y. S., Kang, S. W., Yang, C. W., Kim, N. H., Kim, H. J., Park, J. M., Lee, J. E., Jung, H. Y., Choi, J. Y., Park, S. H., Kim, C. D., & Kim, Y. L. (2015). Differential effect of viral hepatitis infection on mortality among Korean maintenance dialysis patients: A prospective multicenter cohort study. PloS one, 10(8), [e0135476]. https://doi.org/10.1371/journal.pone.0135476