Effect of Dialysis Modality on Survival of Hepatitis C-Infected ESRF Patients

Bose, Bhadran; McDonald, S.; Hawley, Carmel M.; Brown, Fiona G.; Badve, Sunil V.; Wiggins, Kathryn J.; Bannister, Kym M.; Boudville, Neil; Clayton, Philip; Johnson, David W.

doi:10.2215/cjn.02200311

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…Several other studies have reported that an extremely low anti-viral treatment proportion in dialysis patients with HCV infection, 13 , 17 which is similar to our findings. Our data suggested that in HCV-infected ESRD patients, receiving HD or PD had similar risks of mortality; which is consistent with the report by Bose et al 18 …”

Section: Discussionsupporting

confidence: 93%

Interferon-Based Treatment of Hepatitis C Virus Infection Reduces All-Cause Mortality in Patients With End-Stage Renal Disease

et al. 2015

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The long-term survival of end-stage renal disease (ESRD) patients with hepatitis C virus (HCV) infection who received interferon treatment has not been extensively evaluated.The HCV cohort was the ESRD patients with de novo HCV infection from 2004 to 2011; they were classified into treated and untreated groups according to interferon therapy records. Patients aged <20 years and those with a history of hepatitis B, kidney transplantation, or cancer were excluded. The control cohort included ESRD patients without HCV infection matched 4:1 to the HCV cohort by age, sex, and year of ESRD registration. We followed up all study participants until kidney transplantation, death, or the end of 2011, whichever came first. We assessed risk of all-cause mortality by using the multivariate Cox proportional hazard model with time-dependent covariate.In the HCV cohort, 134 patients (6.01%) received interferon treatment. Compared with the uninfected control cohort, the treated group had a lower risk of death (hazard ratio 0.47, 95% confidence interval [CI] 0.22–0.99). The untreated group had a 2.62-fold higher risk (95% CI 1.24–5.55) of death compared with the treated group. For the HCV cohort without cirrhosis or hepatoma, the risk of death in the treated group was further markedly reduced (hazard ratio 0.17, 95% CI 0.04–0.68) compared with that in the control cohort.For ESRD patients with HCV infection, receiving interferon treatment is associated with a survival advantage. Such an advantage is more prominent in HCV patients without cirrhosis or hepatoma.

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Section: Discussionsupporting

confidence: 93%

Interferon-Based Treatment of Hepatitis C Virus Infection Reduces All-Cause Mortality in Patients With End-Stage Renal Disease

et al. 2015

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“…The adverse and independent effect of HCV on cardiovascular mortality after renal transplantation has been also noted [25]. Bose et al [31] found that coronary artery disease played an independent and significant role on all-cause mortality in a large cohort of HCV-infected end-stage renal failure patients. Oyake et al [32] prospectively measured aortic stiffness in 94 dialysis patients and observed that HCV viraemia was per se associated with high pulse-wave velocimeter measurements.…”

Section: Discussionmentioning

confidence: 80%

“…Bose et al. [31] found that coronary artery disease played an independent and significant role on all‐cause mortality in a large cohort of HCV‐infected end‐stage renal failure patients. Oyake et al.…”

Section: Discussionmentioning

confidence: 99%

Impact of hepatitis C on survival in dialysis patients: a link with cardiovascular mortality?

Fabrizi

Dixit

Messa

2012

Journal of Viral Hepatitis

156

129

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Summary. Recent evidence has been accumulated showing that anti‐HCV‐positive serologic status is significantly associated with lower survival in dialysis populations, but the mechanisms underlying this negative relationship are still unclear. The aim of this study was to conduct a systematic review of the published medical literature concerning the impact of hepatitis C virus (HCV) infection on all‐cause and disease‐specific mortality of patients on regular dialysis. The relative risk of all‐cause, cardiovascular and liver disease‐related mortality was regarded as the most reliable outcome end‐point. Study‐specific relative risks were weighted by the inverse of their variance to obtain fixed‐ and random effect pooled estimates for mortality with HCV across the published studies. We identified fourteen observational studies involving 145 608 unique patients on long‐term dialysis. Pooling of study results demonstrated that anti‐HCV antibody was an independent and significant risk factor for death in patients on maintenance dialysis. The summary estimate for adjusted relative risk (all‐cause mortality) was 1.35 with a 95% confidence interval (CI) of 1.25–1.47. Stratified analysis showed that the adjusted RR for liver disease‐related death was 3.82 (95% CI, 1.92; 7.61); heterogeneity statistics, Ri = 0.58 (P‐value by Q‐test = 0.087). The adjusted RR for cardiovascular mortality was 1.26 (95% CI, 1.10; 1.45); no heterogeneity was found (NS). This meta‐analysis of observational studies indicates that anti‐HCV‐positive patients on dialysis have an increased risk of either liver or cardiovascular disease‐related mortality compared with anti‐HCV‐negative patients. Further studies are in progress to understand better the link between HCV and cardiovascular risk among patients on maintenance dialysis.

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“…Bose et al . analyzed a large cohort of HCV-infected individuals ( n =424) treated with haemodialysis ( n =290) and peritoneal dialysis ( n =134) in Australia and New Zealand over the period 1994-2008, and found that coronary artery disease (CAD) was an independent risk factor for mortality, 1.75 (1.34 to 2.30), P <0.01 [17]. Butt et al .…”

Section: Hcv and Cardiovascular Mortality Risk In Dialysis Populationmentioning

confidence: 99%

Recent Advances on Hepatitis C Virus in Dialysis Population

Fabrizi

Martin

2014

Kidney Blood Press Res

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Hepatitis C virus (HCV) infection remains common among patients undergoing regular dialysis and good evidence supports the detrimental role of HCV on survival in patients undergoing maintenance dialysis. According to an updated meta-analysis of clinical studies (n=15; 195,370 unique patients on maintenance dialysis), the summary estimate for adjusted relative risk (all-cause mortality) with anti-HCV across the published studies was 1.32 with a 95% Confidence Intervals of 1.24; 1.42, homogeneity assumption was not rejected. Various mechanisms support the excess death risk of HCV-infected patients on regular dialysis, in addition to liver disease-related mortality. The adjusted relative risk for cardiovascular mortality among HCV-infected patients on regular dialysis was 1.26 (95% Confidence Intervals, 1.10; 1.45); the increased cardiovascular mortality in anti-HCV positive patients has been associated in part to malnutrition and chronic inflammation. The current standard of care for HCV in dialysis population is combined antiviral therapy (pegylated interferon plus ribavirin) with a rate of viral response of around 60%. Triple therapy with telaprevir proved to be effective and safe in dialysis patients with HCV but only anecdotal evidence exists. Antiviral treatment of HCV-infected patients on maintenance dialysis could lead to cure the liver damage and the extrahepatic complications. The future availability of all-oral interferon/ribavirin free regimens for antiviral treatment of HCV will help nephrologists to improve survival in this high-risk group.

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Effect of Dialysis Modality on Survival of Hepatitis C-Infected ESRF Patients

Cited by 7 publications

References 20 publications

Interferon-Based Treatment of Hepatitis C Virus Infection Reduces All-Cause Mortality in Patients With End-Stage Renal Disease

Interferon-Based Treatment of Hepatitis C Virus Infection Reduces All-Cause Mortality in Patients With End-Stage Renal Disease

Impact of hepatitis C on survival in dialysis patients: a link with cardiovascular mortality?

Recent Advances on Hepatitis C Virus in Dialysis Population

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