When hemodialysis patients are infected with HBV/HCV, what are their comorbidities?

Introduction Hemodialysis patients are at higher risk of hepatitis B virus (HBV) and hepatitis C virus (HCV).

Both HBV and HCV infection can increase the risk of end-stage liver disease and extrahepatic comorbidities.

Scholars from Taiwan region of my country conducted an observational study to evaluate the prevalence of liver and extrahepatic comorbidities in hemodialysis patients, compared with patients not infected with viral hepatitis in patients infected with HBV or HCV Happening.

Study Introduction A total of 1910 hemodialysis patients from 23 hemodialysis centers were enrolled, including 159 HCV viremia patients (HCV group), 217 HBV surface antigen (HBsAg) seropositive patients (HBV group), and 1534 patients with anti- HCV and HBsAg seronegative patients (NBNC group).

According to the 10th revised edition of the International Classification of Diseases, comorbidities are divided into 10 categories, and the researchers in this study will further classify them into broader categories.

The results of the study were that the average age of 1910 patients was 64.
6 years, of which male patients accounted for 52.
7%.

Most hemodialysis patients (n=1834, 96%) have at least one comorbidity, and the average number of comorbidities per person is 2.
9±1.
5.

The four most common comorbidities are essential hypertension, diabetes, ischemic heart disease, and hyperlipidemia (Table 1).

The average number of comorbidities per person in the HCV group (3.
3±1.
7) was significantly higher than that in the HBV group (2.
7±1.
5, P<0.
001) and the NBNC group (2.
9±1.
5, P=0.
004), mainly due to the ischemic nature of the HCV group The prevalence of heart disease, respiratory disorders and mental/behavioral disorders is high (Table 1).

Table 1 The comorbidity of all hemodialysis patients (n=1910) The HBV group and the NBNC group showed a comparable burden of comorbidities.

Discuss that this study has certain limitations.

First of all, although HBsAg is negative, researchers cannot rule out the possibility of occult or previous HBV infection in hemodialysis patients, especially in countries where HBV is prevalent, which may affect the characteristics of patients and the prevalence of comorbidities.

Second, all patients in the HCV group have not received direct antiviral drugs (DAA) treatment, and the investigator's data may be potentially biased.

Third, the cohort of this study shows that the proportion of men in the HBV group is higher, which may affect the incidence of complications.

A study of 206,374 patients undergoing hemodialysis from 12 countries showed that there are certain gender-dependent differences in the incidence of comorbidities in patients.

Finally, different research centers have different reports on the prevalence of comorbidities.

However, under the authorization of Taiwan Health Insurance, every hemodialysis center can access all comorbidity information.

In short, hemodialysis patients are more likely to have multiple comorbidities.

Among them, compared with patients infected with HBV and NBNC, hemodialysis patients infected with HCV showed a higher burden of complications, especially the prevalence of ischemic heart disease, respiratory disorders and mental/behavioral disorders.

The average number of comorbidities in HBV patients is comparable to that of NBNC patients.

Related reading Literature index of survival benefits of hemodialysis patients receiving anti-HCV virus therapy: Hsu PY, Wei YJ, Liang PC, et al.
Comorbidities in patients with chronic hepatitis C and hepatitis B on hemodialysis[J].
J Gastroenterol Hepatol.
2021 Mar 2.
E-mail for submission: tougao@medlive.
cn