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A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Hepatitis C virus infection and the prevalence of renal insufficiency
Lorien S Dalrymple1, Thomas Koepsell, Joshua Sampson
1Health Services Research and Development Northwest Center of Excellence, Seattle, WA 98108, USA. dalrympl@u.washington.edu
Insights
Hepatitis C virus (HCV) infection is linked to a higher risk of kidney problems. This study found HCV-positive veterans had a significantly increased odds of renal insufficiency.
Area of Science:
- Nephrology
- Infectious Diseases
- Epidemiology
Background:
- Hepatitis C virus (HCV) is known to cause kidney damage.
- The precise relationship between HCV and renal dysfunction requires further investigation.
Purpose of the Study:
- To determine the prevalence of renal insufficiency in veterans with HCV.
- To assess the association between HCV infection and the risk of developing renal insufficiency.
Main Methods:
- Retrospective cohort study of 25,782 veterans tested for HCV antibodies between 1999-2004.
- Renal insufficiency defined as creatinine ≥1.5 mg/dl.
- Multivariate logistic regression used to analyze the association between HCV and renal insufficiency, adjusting for comorbidities.
Main Results:
- HCV-positive veterans (4.8%) had a lower crude prevalence of renal insufficiency than HCV-negative veterans (6.0%).
- After adjusting for age, race, gender, diabetes, and hypertension, HCV-positive veterans showed a 40% higher odds of renal insufficiency (OR 1.40; 95% CI 1.11-1.76).
Conclusions:
- Hepatitis C virus infection is associated with an increased prevalence of renal insufficiency.
- HCV may represent an independent risk factor for renal dysfunction in the veteran population.
Background:
Hepatitis C virus (HCV) is associated with pathologic changes in the kidney. However, the association between HCV and renal dysfunction is not well defined.
Design, Setting, Participants, And Measurements:
This study estimated the prevalence of renal insufficiency among veterans who received care through the Veterans Affairs Puget Sound Health Care System. The study population consisted of veterans who underwent HCV antibody testing between January 1, 1999, and December 31, 2004, and had at least one primary care or medical subspecialty visit and at least one outpatient creatinine measurement within the 18 mo before antibody testing. Veterans were excluded when they had a history of chronic dialysis, creatinine >5 mg/dl, or renal transplantation. Study data were extracted from the electronic medical record. Renal insufficiency was defined as a creatinine level > or =1.5 mg/dl. Multivariate logistic regression was performed to estimate the risk for renal insufficiency associated with HCV. Among 25,782 eligible veterans, 1928 were HCV antibody positive and 23,854 were HCV antibody negative.
Results:
Although the proportion with renal insufficiency was lower for antibody-positive versus -negative veterans (4.8 versus 6.0%), after adjustment for age, race, gender, diabetes, and hypertension, HCV-positive veterans had a 40% higher odds for renal insufficiency (odds ratio 1.40; 95% confidence interval 1.11 to 1.76) as compared with HCV-negative veterans.
Conclusions:
HCV was associated with an increased prevalence of renal insufficiency.
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