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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
10
pubmed:dateCreated
2007-9-18
pubmed:abstractText
The impact of hepatitis C virus (HCV) and other comorbid conditions upon survival is not well quantified in patients on dialysis. We identified HCV-infected and uninfected persons in the USRDS using claims data in 1997-1998 and followed until September 22, 2002 or death. We used Gray's time-varying coefficients model to examine factors associated with survival. Subjects with a renal transplant were excluded. A total of 5737 HCV-infected and 11 228 HCV-uninfected persons were identified. HCV-infected subjects were younger (mean age 57.8 vs 65.3 years), more likely to be male (57.6%vs 49.6%) and black (54.0%vs 36.4%). They were more likely to have a diagnosis of drug (16.5%vs 4.6%) and alcohol use (14.0%vs 3.1%), and to be human immunodeficiency virus (HIV) co-infected (7.4%vs 1.8%) (all comparisons, P < 0.0005). In an adjusted Gray's time-varying coefficient model, HCV was associated with an increased risk of mortality (P < 0.0005). The hazards were highest at the time of HCV diagnosis and decreased to a stable level 2 years after diagnosis. Other factors associated with increased risk of mortality were (P < 0.0005 unless stated) HIV coinfection; diagnosis of drug use (P = 0.001); coronary artery disease (P = 0.006); stroke; diabetes as the primary cause for renal failure; peripheral vascular disease; depression and presence of anaemia. HCV was associated with higher risk of death in patients on dialysis, even after adjusting for concurrent comorbidities. The risk was highest at the time of HCV diagnosis and stabilized over time. Clinical trials of HCV screening and treatment to reduce mortality in this population are warranted.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
1352-0504
pubmed:author
pubmed:issnType
Print
pubmed:volume
14
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
688-96
pubmed:meshHeading
pubmed-meshheading:17875003-Anemia, pubmed-meshheading:17875003-Cohort Studies, pubmed-meshheading:17875003-Comorbidity, pubmed-meshheading:17875003-Coronary Disease, pubmed-meshheading:17875003-Diabetes Mellitus, pubmed-meshheading:17875003-HIV Infections, pubmed-meshheading:17875003-Hepatitis C, pubmed-meshheading:17875003-Humans, pubmed-meshheading:17875003-International Classification of Diseases, pubmed-meshheading:17875003-Kidney Failure, Chronic, pubmed-meshheading:17875003-Male, pubmed-meshheading:17875003-Middle Aged, pubmed-meshheading:17875003-Peripheral Vascular Diseases, pubmed-meshheading:17875003-Renal Dialysis, pubmed-meshheading:17875003-Retrospective Studies, pubmed-meshheading:17875003-Risk Factors, pubmed-meshheading:17875003-Substance-Related Disorders, pubmed-meshheading:17875003-Treatment Outcome, pubmed-meshheading:17875003-United States
pubmed:year
2007
pubmed:articleTitle
Impact of hepatitis C virus infection and other comorbidities on survival in patients on dialysis.
pubmed:affiliation
Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. butta@dom.pitt.edu
pubmed:publicationType
Journal Article, Research Support, N.I.H., Extramural