Comorbidities in patients with chronic hepatitis C and hepatitis B on hemodialysis

J Gastroenterol Hepatol. 2021 Aug;36(8):2261-2269. doi: 10.1111/jgh.15480. Epub 2021 Mar 10.

Abstract

Background and aim: Hemodialysis patients are at increased risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Both HBV and HCV infections lead to risks of end-stage liver diseases and extrahepatic manifestations. This study aimed to investigate hepatic and extrahepatic comorbidities in hemodialysis patients with HBV or HCV infections compared with those without viral hepatitis.

Methods: A total of 1910 hemodialysis patients, including 159 HCV viremic patients (HCV group), 217 seropositive for HBV surface antigen (HBsAg, HBV group) and 1534 seronegative for both anti-HCV and HBsAg (non-B and non-C [NBNC] group), from 23 hemodialysis centers were enrolled. Comorbidities were classified into 10 categories by the International Classification of Diseases-10th Revision.

Results: Among the 1910 patients, the mean age was 64.6 years, and 52.7% were male patients. A total of 1834 (96%) patients had at least one comorbidity, and the mean number of comorbidities was 2.9 ± 1.5 per person. The three most common comorbidities were hypertension, diabetes, and ischemic heart diseases. The mean number of comorbidities per person was significantly higher in the HCV group (3.3 ± 1.7) than in the HBV (2.7 ± 1.5, P < 0.001) and NBNC groups (2.9 ± 1.5, P = 0.004), mainly due to the higher prevalence of ischemic heart disease, respiratory disorders, and mental/behavioral disorders. The HBV and NBNC groups exhibited comparable burdens of comorbidities.

Conclusions: Hemodialysis patients had a high prevalence of multiple comorbidities. Hemodialysis patients with HCV exhibited a higher burden of comorbidities, especially ischemic heart diseases, respiratory disorders, and mental/behavioral disorders, than HBV and NBNC patients did.

Keywords: comorbidities; hemodialysis; hepatitis B virus; hepatitis C virus.

MeSH terms

  • Comorbidity
  • Female
  • Hepacivirus
  • Hepatitis B Surface Antigens
  • Hepatitis B virus
  • Hepatitis B* / epidemiology
  • Hepatitis C / epidemiology
  • Hepatitis C, Chronic* / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia*
  • Prevalence
  • Renal Dialysis / adverse effects

Substances

  • Hepatitis B Surface Antigens