Patterns in the prevalence of hepatitis C virus infection at the start of hemodialysis in Japan |
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Authors: | Yuko Iwasa Shigeru Otsubo Orie Sugi Keitaro Sato Yukari Asamiya Aya Eguchi Tomihito Iwasaki Nami Matsuda Kan Kikuchi Norisato Ikebe Naoko Miwa Naoki Kimata Keiko Uchida Shigeharu Uchida Kosaku Nitta Takashi Akiba |
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Institution: | (1) Department of Medicine, Kidney Center, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan;(2) Department of Blood Purification, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan;(3) Tokyo Metropolitan Red Cross Blood Center, Tokyo, Japan |
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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).
Conclusion 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. |
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Keywords: | Hepatitis C Hemodialysis Diabetic nephropathy Diabetes mellitus End-stage kidney disease (ESKD) Liver chirrhosis |
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