Article thumbnail

Association of HCV Core Antigen Seropositivity with Long-Term Mortality in Patients on Regular Hemodialysis

By Akihiko Kato, Takako Takita, Mitsuyoshi Furuhashi, Taiki Fujimoto, Hiroo Suzuki, Yukitaka Maruyama, Yukitoshi Sakao and Hiroaki Miyajima


Anti-hepatitis C virus (HCV) antibody seropositivity is independently associated with poor prognosis in hemodialysis (HD) patients. However, anti-HCV antibody cannot distinguish between patients with active infection and those who have recovered from infection. We therefore aimed in this study to examine the association of HCV core antigen (HCVcAg) seropositivity with mortality in HD patients. We first measured serum HCVcAg using an immunoradiometric assay and anti-HCV antibody in 405 patients on regular HD, and followed them for 104 months. There were 82 patients (20.2%) who had been positive for anti-HCV antibodies; 57 (69.5%) of these were positive for HCVcAg. During the follow-up, 29 patients were excluded, so we tested the association of HCVcAg seropositivity with all-cause, cardiovascular (CV) and non-CV mortalities in 376 patients. A total of 209 patients (55.6%) had expired during the observational period, 92 out of them due to CV causes. After adjusting for comorbid parameters, HCVcAg was independently associated with overall mortality (HR 1.61, 95% CI 1.05–2.47, p < 0.05). HCV infection was significantly related to liver disease-related mortality. Past HCV infection also contributed to CV mortality (HR 2.63, 95% CI 1.27–5.45, p < 0.01). In contrast, anti-HCV antibody and HCVcAg seropositivities did not associate with infectious disease-related and cancer-related (expect for hepatocellular carcinoma) mortality. It follows from these findings that HCVcAg serology is associated with all-cause and CV mortality in HD patients

Topics: Original Paper
Publisher: S. Karger AG
OAI identifier:
Provided by: PubMed Central

Suggested articles


  1. (2001). al: Adverse impact of hepatitis C virus infection on renal replacement therapy and renal transplant patients in Australia and New Zealand. Transplantation
  2. (2008). al: Diagnostic utility of hepatitis C virus core antigen in hemodialysis patients. Clin Biochem
  3. (2011). al: Different kinetics of HBV and HCV during haemodialysis and absence of seronegative viral hepatitis in patients with end-stage renal disease. Nephrol Dial Transplant
  4. (2007). al: Hepatitis C virus and death risk in hemodialysis patients.
  5. (2005). al: National surveillance of dialysis-associated diseases in the United States. Semi Dial
  6. (2011). al: Seropositivity for anti-HCV core antigen is independently associated with increased all-cause, cardiovascular, and liver disease related mortality in hemodialysis patients.
  7. (2007). al: Simple blood tests as noninvasive markers of liver fibrosis in hemodialysis patients with chronic hepatitis C virus infection. Hepatology
  8. (2007). al: The impact of hepatitis C virus infection on survival in dialysis patients: meta-analysis of observational studies.
  9. (2010). Arduino MJ: Epidemiology, surveillance, and prevention of hepatitis C virus infections in hemodialysis patients.
  10. (2005). Daar ES: Diagnostic discordance for hepatitis C virus infection in hemodialysis patients.
  11. (1998). et al: Effect of hepatitis C infection and renal transplantation on survival in end-stage renal disease. Kidney Int
  12. (2003). et al: Elevation of blood thioredoxin in hemodialysis patients with hepatitis C virus infection. Kidney Int
  13. (2006). et al: Epidemiology of hepatitis C virus among long-term dialysis patients: a 9-year study in Italian region.
  14. (2005). et al: Evaluation of a total core antigen assay for the diagnosis of hepatitis C virus infection in haemodialysis patients.
  15. et al: Frequencies of hepatitis B and C infections among haemodialysis and peritoneal patients in Asia-Pacific countries: analysis of registry data.
  16. (2009). et al: Increased rate of death related to presence of viremia among hepatitis C virus antibody-positive subjects in a community-based cohort study. Hepatology
  17. et al: Lack of de novo hepatitis C virus infections and absence of nosocomial transmission of GB virus in a large cohort of German haemodialysis patients.
  18. (2005). et al: Novel assay using total hepatitis C virus (HCC) core antigen quantification for diagnosis of HCV infection in dialysis patients.
  19. (2008). et al: Overview of regular dialysis treatment in
  20. (2010). et al: Standardized prevalence ratios for chronic hepatitis C virus infection among adult Japanese hemodialysis patients.
  21. (2005). et al: Usefulness of a new immuno-radiometric assay to detect hepatitis C core antigen in a community-based population. J Viral Hepat
  22. KDIGO clinical practice guidelines for the prevention, diagnosis, evaluation, and treatment of hepatitis C in chronic kidney disease. Kidney Int 2008; 73(suppl 109):S1–S99.
  23. (2005). LG: Clinical characteristics and mortality in hepatitis Cpositive haemodialysis patients: a population based study. Nephrol Dial Transplant
  24. (1998). Risk of death among chronic dialysis patients infected with hepatitis C virus.
  25. (2000). Sato C: Prognosis of anti-hepatitis C virus antibody-positive patients on regular hemodialysis therapy.

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.