Meta-analysis: Effect of hepatitis C virus infection on mortality in dialysis

F. Fabrizi, Paul Martin, V. Dixit, S. Bunnapradist, G. Dulai

Research output: Contribution to journalArticle

121 Citations (Scopus)

Abstract

Background: The natural history of hepatitis C virus infection among patients on long-term dialysis treatment remains incompletely understood. Efforts to elucidate the natural history of hepatitis C virus in this population are difficult because of the slowly progressive nature of hepatitis C virus with often an unrecognized onset in patients whose life-expectancy is substantially diminished by end-stage renal disease. Aim: To conduct a systematic review of the published medical literature concerning the impact of hepatitis C virus infection on the survival of patients receiving chronic dialysis. The relative risk of mortality was regarded as the most reliable outcome end-point. Methods: We used the random effects model of DerSimonian and Laird to generate a summary estimate of the relative risk for mortality with hepatitis C virus across the published studies. Results: We identified four clinical trials (2341 unique patients); three (75%) of them were prospective, cohort studies; the fourth was a case-control study. Pooling of study results demonstrated that presence of antihepatitis C virus antibody was an independent and significant risk factor for death in patients on maintenance dialysis. The summary estimate for relative risk was 1.57 with a 95% confidence interval (CI) of 1.33-1.86. A test for homogeneity of the relative risks across the four studies gave a P-value of 0.77. As a cause of death, hepatocellular carcinoma and liver cirrhosis were significantly more frequent among antihepatitis C virus-positive than -negative dialysis patients. Conclusions: This meta-analysis demonstrates that antihepatitis C virus-positive patients on dialysis have an increased risk of mortality compared with hepatitis C virus-negative patients. The excess risk of death in hepatitis C virus-positive patients may be at least partially attributed to chronic liver disease with its attendant complications. Clinical trials with extended follow-up are currently under way to assess the effect of hepatitis C virus treatment on the excess risk of mortality in this population.

Original languageEnglish
Pages (from-to)1271-1277
Number of pages7
JournalAlimentary Pharmacology and Therapeutics
Volume20
Issue number11-12
DOIs
StatePublished - Dec 1 2004
Externally publishedYes

Fingerprint

Virus Diseases
Hepacivirus
Meta-Analysis
Dialysis
Mortality
Viruses
Natural History
Clinical Trials
Life Expectancy
Liver Cirrhosis
Population
Chronic Kidney Failure
Case-Control Studies
Liver Diseases
Cause of Death
Hepatocellular Carcinoma
Chronic Disease
Cohort Studies
Maintenance
Prospective Studies

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Meta-analysis : Effect of hepatitis C virus infection on mortality in dialysis. / Fabrizi, F.; Martin, Paul; Dixit, V.; Bunnapradist, S.; Dulai, G.

In: Alimentary Pharmacology and Therapeutics, Vol. 20, No. 11-12, 01.12.2004, p. 1271-1277.

Research output: Contribution to journalArticle

Fabrizi, F. ; Martin, Paul ; Dixit, V. ; Bunnapradist, S. ; Dulai, G. / Meta-analysis : Effect of hepatitis C virus infection on mortality in dialysis. In: Alimentary Pharmacology and Therapeutics. 2004 ; Vol. 20, No. 11-12. pp. 1271-1277.
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