HCV Ups Anemia-Related Event Risks in Hemodialysis Patients

Hepatitis C viral infection found to increase likelihood of requiring blood transfusions and hemoglobin levels dropping below 8.5 g/dL.
Hepatitis C viral infection found to increase likelihood of requiring blood transfusions and hemoglobin levels dropping below 8.5 g/dL.

SAN DIEGO—Hepatitis C virus (HCV) infection in hemodialysis (HD) patients is associated with an increased risk of anemia-related events, according to study findings presented at Kidney Week.

Brian Bieber, MPH, MS, of Arbor Research Collaborative for Health in Ann Arbor, Mich., and colleagues made the discovery after they analyzed data from 67,188 HD patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective cohort study of adult in-center HD patients in 21 countries. Of these patients, 5,378 were HCV-positive and 62,173 were HCV-negative at DOPPS enrollment.

After adjusting for confounders, HCV-positive patients had a significant 41% increased risk of requiring a red blood cell transfusion and a 15% increased risk of having their hemoglobin level drop below 8.5 g/dL compared with HCV-negative patients. In addition, the investigators observed a trend toward more frequent gastrointestinal (GI) bleeds in HCV-positive patients.

The reasons for the elevated risk for anemia-related events among HCV-positive patients may include GI blood loss due to portal hypertension, coagulation deficiencies, and/or hypersplenism, according to the researchers.

The investigators noted that HCV remains common among HD patients, with prevalence rates of 6%–20%. Although it has been known that HCV infection is associated with elevated mortality risk in HD patients, the association of HCV infection with anemia-related events has not been well characterized.

Merck, Sharp and Dohme, Corp. funded the study.

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