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A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
HCV infection and the incidence of CKD
Adeel A Butt1, Xiaoqiang Wang, Linda F Fried
1University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. butta@dom.pitt.edu
Insights
Hepatitis C virus (HCV) infection increases the risk of developing chronic kidney disease (CKD) and shortens the time to its onset. Targeted monitoring for CKD is recommended for HCV-infected individuals.
Area of Science:
- Nephrology
- Hepatology
- Infectious Diseases
Background:
- The relationship between Hepatitis C Virus (HCV) infection and the development of Chronic Kidney Disease (CKD) is not fully understood, especially considering traditional risk factors and therapies.
- Existing research has not clearly defined the risk of incident CKD in HCV-infected individuals.
Purpose of the Study:
- To investigate the association between HCV infection and the risk of developing incident CKD stages 3-5.
- To determine if HCV infection influences the time to CKD onset.
- To explore the impact of traditional CKD risk factors in HCV-infected and uninfected populations.
Main Methods:
- A national cohort study was conducted using data from the ERCHIVES database.
- HCV-infected veterans (n=18,002) were compared with HCV-uninfected controls (n=25,137) from 2001-2006.
- Statistical analyses, including hazard ratios (HR) and Kaplan-Meier curves, were used to assess CKD risk and time to onset.
Main Results:
- HCV-infected patients exhibited a higher risk of developing CKD stages 3-5 (HR, 1.30; 95% CI, 1.23-1.37).
- Despite a lower prevalence of diabetes, hypertension, and dyslipidemia, HCV infection was linked to a shorter time to CKD.
- Decompensated liver disease significantly predicted CKD in both HCV-infected and uninfected groups.
Conclusions:
- HCV infection is an independent risk factor for CKD development and progression.
- HCV-infected individuals require focused screening and monitoring for CKD.
- Further research is needed to address limitations such as lack of proteinuria data and limited representation of women.
Background:
The risk of hepatitis C virus (HCV) infection upon incident chronic kidney disease (CKD) in the presence of traditional risk factors and renal-modifying therapy is not well known.
Study Design:
National cohort study.
Setting & Participants:
HCV-infected and -uninfected veterans in ERCHIVES (Electronically Retrieved Cohort of HCV Infected Veterans) in 2001-2006.
Predictor:
HCV infection.
Outcomes:
Incident CKD stages 3-5.
Results:
We identified 18,002 patients with HCV infection and 25,137 controls with estimated glomerular filtration rate >60 mL/min/1.73 m(2) at baseline. HCV-infected patients had a lower prevalence of several CKD risk factors, including diabetes (22.9% vs 26.6%), hypertension (52.4% vs 60.8%), and dyslipidemia (39.3% vs 73.9%; P < 0.001). HCV infection was associated with a higher risk of developing CKD stages 3-5 (HR, 1.30; 95% CI, 1.23-1.37). Increasing age, hypertension, and diabetes were associated with significantly higher risks of developing CKD in HCV-infected patients and controls. Decompensated liver disease was a strong predictor of CKD in HCV-infected patients (HR, 3.37; 95% CI, 3.10-3.66) and HCV-uninfected controls (HR, 2.04; 95% CI, 1.84-2.25). In Kaplan-Meier analysis, HCV-infected persons had a shorter time to CKD.
Limitations:
Lack of proteinuria data; small number of women.
Conclusions:
HCV infection is associated with higher risk and shorter time to CKD despite having a lower prevalence of many CKD risk factors. HCV-infected persons should have targeted monitoring for the development and progression of CKD.
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