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Hepatitis C Is Less Aggressive in Hemodialysis Patients than in Nonuremic Patients

2008; Lippincott Williams & Wilkins; Volume: 3; Issue: 5 Linguagem: Inglês

10.2215/cjn.01330308

1555-905X

José Eduardo Trevizoli, Raissa de Paula Menezes, Lara Franciele Ribeiro Velasco, Regina Maria Santos de Amorim, Mauro Birche de Carvalho, Liliana Sampaio Costa Mendes, Columbano Junqueira Neto, JoseCombining Acute Accent Roberto de Deus Macedo, Francisco de Assis, Rocha Neves,

Hepatitis B Virus Studies

The severity of liver disease among hepatitis C patients on hemodialysis is controversial. The aim of this study was to compare the clinical, biochemical, and liver histologic characteristics of hepatitis C virus (HCV) in hemodialysis patients and in those with normal renal function.A case-control study was carried out with 36 HCV patients on hemodialysis and 37 HCV patients with normal renal function matched for gender, age at infection, and estimated time of infection.HCV patients on hemodialysis had lower levels of alanine aminotransferase and lower viral load. Hepatic fibrosis was significantly higher in the patients with normal renal function (73%) than in hemodialysis patients (47.2%, P < 0.025); the same was observed for inflammatory activity (control group 59.5% versus hemodialysis patients 27.7%, P = 0.003). In addition, the risk of tissue inflammation was four times lower in hemodialysis patients (odds ratio = 0.23, P < 0.004), and severe inflammatory activity on biopsy was the only independent risk factor for fibrosis (P < 0.001).The lower biochemical and inflammatory activities observed in hemodialysis patients suggest that hemodialysis and uremia may have a protective role against progression of the disease caused by HCV.