Chronic HCV Linked to Higher CKD Risk

Chronic hepatitis C virus (HCV) infection is associated with an increased risk of chronic kidney disease (CKD), with the extent of risk depending on viral load and genotype, reports a study in Kidney International.

The researchers analyzed data on 13,805 Taiwanese adults from a prospective, community-based cohort study. Mean age at enrollment was 47.5 years. Based on detectable HCV load, 431 patients had chronic HCV infection. Chronic HCV infection, viral load, and phenotype were evaluated for association with CKD, defined as consecutive proteinuria or an estimated glomerular filtration rate of less than 60 mL/min/1.73 m2.

Subjects with chronic HCV infection had about a twofold increase in CKD: adjusted prevalence odds ratio (POR) 1.91. Risk was highest for chronically infected patients in the highest tertile of serum HCV RNA: POR 3.44.

Among participants with high HCV viral load, PORs were 2.62 for those with HCV genotype 1 and 4.99 for those with genotype 2. On subanalysis including only those with detectable serum HCV RNA, the risk of CKD was about three times higher for those with genotype 2 versus genotype 1.

There is debate over the association between HCV and CKD. Taiwan is an area endemic for HCV and has the highest prevalence of kidney failure worldwide.

This cross-sectional study suggests that chronic HCV infection is an independent risk factor for CKD in Taiwan. Kidney disease risk is particularly high for patients with high HCV viral load and/or HCV genotype 2. The authors call for a prospective study to clarify whether HCV viral load and genotype are associated with an increased likelihood of developing CKD and kidney failure [Lai T-S, et al. High hepatitis C viral load and genotype 2 are strong predictors of chronic kidney disease. Kidney Int 2017; 92:703–709].

October/November 2017 (Vol. 9, Number 10 & 11)