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Sci Rep. 2019 Feb 13;9(1):1910. doi: 10.1038/s41598-018-36437-6.

Association of Hepatitis C and B Virus Infection with CKD and Impact of Hepatitis C Treatment on CKD.

Zhang H1,2, Xu H1,3, Wu R1,3, Yu G1, Sun H1, Lv J1, Wang X1,3, Chi X1,3, Gao X1,3, Kong F1, Zhang M1, Hang L1, Jiang J4, Pan Y5, Niu J6,7.

Author information

1
Department of Hepatology, The First Hospital of Jilin University, Jilin University, Changchun, 130021, China.
2
Department of Hepatology, Jiangsu Taizhou People's Hospital, Taizhou, 225300, China.
3
Jilin Province Key Laboratory of Infectious Diseases, Laboratory of Molecular Virology, Changchun, 130021, China.
4
Department of Clinical Epidemiology, The First Hospital, Jilin University, No. 71 Xinmin Street, Changchun, 130021, China.
5
Department of Hepatology, The First Hospital of Jilin University, Jilin University, Changchun, 130021, China. panyu20000@163.com.
6
Department of Hepatology, The First Hospital of Jilin University, Jilin University, Changchun, 130021, China. junqi_niu@163.com.
7
Jilin Province Key Laboratory of Infectious Diseases, Laboratory of Molecular Virology, Changchun, 130021, China. junqi_niu@163.com.

Abstract

Hepatitis C virus (HCV) infection greatly increases the risk of nephropathy. In this observational study, we aimed to explore the relationship between viral hepatitis infection and chronic kidney disease (CKD), identify risk factors, and determine the effect of antiviral treatment on CKD in Chinese patients with chronic HCV infection. A total of 2,435 study subjects were enrolled and divided into four groups: the HCV infection, HBV infection, HBV and HCV co-infection, and uninfected control groups. Of these, 207 patients with chronic hepatitis C (CHC) were given standard dual therapy [subcutaneous injection of recombinant interferon (IFN)-α2b and oral ribavirin (RBV)] for 48 weeks. We found that the prevalence of CKD gradually increased with age in all groups and was significantly increased in patients 60 years or older. Multivariate logistic regression analyses showed that persistent HCV infection was significantly associated with CKD [odds ratio (OR), 1.33; 95% confidence interval (CI), 1.06-1.66; P = 0.013], whereas there was no significant link between CKD and spontaneous HCV clearance (OR, 1.23; 95% CI, 0.79-1.90; P = 0.364), HBV infection (OR, 0.73; 95% CI, 0.44-1.19; P = 0.201), or HBV/HCV co-infection (OR, 1.40; 95% CI, 0.81-2.40; P = 0.234). Notably, after anti-HCV therapy, the serum creatinine concentration was significantly decreased (76.0, 75.5-79.4 μmol/L) from the pretreatment level (95.0, 93.0-97.2 μmol/L), both in patients who showed an end of treatment virological response (ETVR) and those who did not (P < 0.001). Also, in both the ETVR and non-ETVR groups, the percentages of patients with an estimated glomerular filtration rate (eGFR) ≥90 ml/min/1.73 m2 increased significantly (P < 0.001), whereas the percentages of those with an eGFR <60 ml/min/1.73 m2 significantly decreased (P < 0.001). In conclusion, persistent HCV infection was independently associated with CKD, and antiviral treatment with IFN plus RBV can improve renal function and reverse CKD in HCV-infected patients.

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