Epidemiology of Hepatitis C Virus Among Long-Term Dialysis Patients: A 9-Year Study in an Italian Region

Anteo Di Napoli, Patrizio Pezzotti, Domenico Di Lallo, Nicola Petrosillo, Claudia Trivelloni, Salvatore Di Giulio

Research output: Contribution to journalArticle

Abstract

Background: Monitoring hepatitis C virus (HCV) antibodies (anti-HCV) in long-term dialysis patients is an important issue of public health. The aim of the study is to analyze the prevalence, seroconversion rate, and impact of HCV-positive serological test results on survival. Methods: We studied 6,412 patients starting long-term dialysis therapy reported to Lazio Dialysis Registry (Italy) between 1995 and 2003. HCV serological status was assessed by using second- or third-generation assays. Patients who were seronegative at the beginning of a period who became seropositive at the end of the same period are defined as seroconverters. Results: In 1995 to 2003, the overall prevalence of anti-HCV among long-term dialysis patients decreased from 30.6% to 15.1%; we did not observe a decrease in prevalence of anti-HCV in those starting dialysis treatment. After a decrease in the first year, HCV seroconversion rates remained stable at approximately 2 cases/100 person-years. Survival at 9 years was lower for both HCV seroconverters and those already anti-HCV positive at dialysis therapy initiation compared with HCV-negative subjects (log-rank test, P <0.001). Results of a multiple Cox model showed that subjects who were or became anti-HCV positive had a hazard ratio of 1.29 (95% confidence interval, 1.15 to 1.44) compared with HCV-negative patients. Conclusion: We did not observe a significant decrease in HCV seroconversion rates in 1995 to 2003. The overall decrease in anti-HCV prevalence could be related to the lower survival probability for both HCV seroconverters and those already HCV positive at long-term dialysis therapy initiation compared with HCV-negative subjects. Our findings confirm that additional efforts should be made to minimize the risk for HCV infection before and during long-term dialysis treatment.

Original languageEnglish
Pages (from-to)629-637
Number of pages9
JournalAmerican Journal of Kidney Diseases
Volume48
Issue number4
DOIs
Publication statusPublished - Oct 2006

Fingerprint

Hepacivirus
Dialysis
Epidemiology
Hepatitis C Antibodies
Survival
Therapeutics
Serologic Tests
Virus Diseases
Proportional Hazards Models
Italy
Registries
Public Health

Keywords

  • epidemiology
  • Hepatitis C virus (HCV) infection
  • long-term dialysis
  • prevalence
  • seroconversion
  • survival

ASJC Scopus subject areas

  • Nephrology

Cite this

Epidemiology of Hepatitis C Virus Among Long-Term Dialysis Patients : A 9-Year Study in an Italian Region. / Di Napoli, Anteo; Pezzotti, Patrizio; Di Lallo, Domenico; Petrosillo, Nicola; Trivelloni, Claudia; Di Giulio, Salvatore.

In: American Journal of Kidney Diseases, Vol. 48, No. 4, 10.2006, p. 629-637.

Research output: Contribution to journalArticle

Di Napoli, Anteo ; Pezzotti, Patrizio ; Di Lallo, Domenico ; Petrosillo, Nicola ; Trivelloni, Claudia ; Di Giulio, Salvatore. / Epidemiology of Hepatitis C Virus Among Long-Term Dialysis Patients : A 9-Year Study in an Italian Region. In: American Journal of Kidney Diseases. 2006 ; Vol. 48, No. 4. pp. 629-637.
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abstract = "Background: Monitoring hepatitis C virus (HCV) antibodies (anti-HCV) in long-term dialysis patients is an important issue of public health. The aim of the study is to analyze the prevalence, seroconversion rate, and impact of HCV-positive serological test results on survival. Methods: We studied 6,412 patients starting long-term dialysis therapy reported to Lazio Dialysis Registry (Italy) between 1995 and 2003. HCV serological status was assessed by using second- or third-generation assays. Patients who were seronegative at the beginning of a period who became seropositive at the end of the same period are defined as seroconverters. Results: In 1995 to 2003, the overall prevalence of anti-HCV among long-term dialysis patients decreased from 30.6{\%} to 15.1{\%}; we did not observe a decrease in prevalence of anti-HCV in those starting dialysis treatment. After a decrease in the first year, HCV seroconversion rates remained stable at approximately 2 cases/100 person-years. Survival at 9 years was lower for both HCV seroconverters and those already anti-HCV positive at dialysis therapy initiation compared with HCV-negative subjects (log-rank test, P <0.001). Results of a multiple Cox model showed that subjects who were or became anti-HCV positive had a hazard ratio of 1.29 (95{\%} confidence interval, 1.15 to 1.44) compared with HCV-negative patients. Conclusion: We did not observe a significant decrease in HCV seroconversion rates in 1995 to 2003. The overall decrease in anti-HCV prevalence could be related to the lower survival probability for both HCV seroconverters and those already HCV positive at long-term dialysis therapy initiation compared with HCV-negative subjects. Our findings confirm that additional efforts should be made to minimize the risk for HCV infection before and during long-term dialysis treatment.",
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AU - Di Napoli, Anteo

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AU - Trivelloni, Claudia

AU - Di Giulio, Salvatore

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