Effect of Hepatitis B and C Virus Infections on Mortality in the Korean Dialysis Patients: a Prospective Multicenter Cohort Study

Abstract

The role of HBV and HCV infections in survival among dialysis patients remains incompletely understood. This study investigated the prevalence of hepatitis B or C infection and its impact on survival in Korean patients on maintenance dialysis. Methods: The study included 3,321 maintenance dialysis patients who underwent hepatitis B antigen (HBsAg) and HCV antibody (Ab) testing from a multicenter prospective cohort study in Korea. HBsAg-positive and HCV Ab-positive patients were matched to hepatitis virus-negative patients using propensity score by a ratio of one to two. We compared the survival of HBsAg and HCV Ab-positive patients to that of hepatitis virus-negative patients. Results: A total of 221 (6.7%) HBsAg-positive and 108 (3.7%) HCV Ab-positive patients were enrolled and followed up for mean 23.5±13.3 months. Patients with dialysis vintage of ≥10 years showed a significantly higher prevalence of HBV and HCV than patients with dialysis vintage of <1 year (HBV 10.2% vs. 5.6%, p=0.011 and HCV 7.5% vs. 3.3%, p=0.003, respectively). After propensity score matching, the cumulative survival was not different between HBsAg-positive and hepatitis virus-negative patients (p=0.370). However, HCV Ab-positive patients showed a significantly lower survival than hepatitis virus-negative patients (p= 0.026). Conclusions: The prevalence of HBV and HCV increases with the time on dialysis. HCV infection in maintenance dialysis patients is associated with an increased risk of mortality.