Association of hepatitis C virus infection status and genotype with kidney disease risk: A population-based cross-sectional study

Abstract

Background Whether there is difference in kidney disease risk between chronic hepatitis C virus (HCV) infection and resolved HCV infection remains inconclusive. Additionally, the impact of different HCV genotypes on kidney disease risk is relatively unknown. Accordingly, we conducted a population-based cross-sectional study to investigate the association of HCV infection status and genotype on kidney disease risk. Methods The study population were adult participants of 1999–2018 National Health and Nutrition Examination Survey in the United States. Chronic and resolved infection were defined as HCV seropositivity with and without detectable HCV RNA, respectively. HCV genotypes were classified into genotype 1, genotype 2, and other genotypes. Prevalent estimated glomerular filtration rate < 60 ml/min/1.73 m2 or urinary albumin creatinine ratio ≥ 30 mg/g was defined as kidney disease. Results The average age of study population (n = 44,998) was 46.7±17.0 years with 49.8% being males. Compared with individuals without HCV infection (n = 44,157), those with resolved (n = 255) or chronic HCV infection (n = 586) had higher prevalence of kidney disease: 14.8%, 23.5%, and 20.1%, respectively (p<0.001). After adjusting for potential confounders, we found that both resolved (adjusted OR: 1.40, 95% CI: 1.02–1.93) and chronic HCV infection (adjusted OR: 1.26, 95% CI: 1.01–1.57) correlated to increased kidney disease risk compared with no HCV infection. Additionally, individuals with HCV genotype 1 (adjusted OR: 1.41, 95% CI: 1.09–1.82) but not genotype 2 or other genotypes had greater kidney disease risk compared with no HCV infection. Furthermore, we observed that genotype 1 had 2-fold higher kidney disease risk (adjusted OR: 2.20, 95% CI: 1.07–4.53) compared with non-genotype 1 HCV infection. Conclusion Both resolved and chronic HCV infection, particularly genotype 1, were associated with higher kidney disease risk.

Hepatitis C virus antibody seropositivity is associated with albuminuria but not peripheral artery disease in patients with type 2 diabetes

“…Therefore, we could not assess the relationship between detectable HCV RNA and UACR or ABI in patients with HCV Ab seropositivity. The risk of kidney disease, defined as a UACR ≥ 30 mg/g or an eGFR < 60 mL/min/1.73 m 2 , has been reported to not be significantly different between resolved HCV infection (undetectable HCV RNA) and chronic HCV infection (detectable HCV RNA) in the patients with HCV Ab seropositivity; however, the risk of kidney disease might be higher in patients with HCV genotype 1 than in those with other HCV genotypes 52 . Fourth, we only included patients enrolled in the P4P program, which has been reported to attenuate chronic diabetic complications 53 – 55 .…”

From Bench to Bedside: Clinical and Biomedical Investigations on Hepatitis C Virus (HCV) Genotypes and Risk Factors for Albuminuria

“…Prevalent eGFR < 60 mL/min/1.73 m 2 or urinary albumin/creatinine ratio ≥ 30 mg/g was defined as kidney disease in this study. They concluded that genotype 1, in both resolved and chronic HCV infections, was associated with higher risk of kidney disease [ 28 ]. In our study, the results show that genotype 2 may have greater risk of albuminuria, instead of focusing on eGFR decline in patients with an HCV infection.…”