Impact of Chronic HCV Infection on Coronary Calcification in Prevalent Haemodialysis Patients

Background: Hepatitis C virus (HCV) chronically infects an estimated 170 million people worldwide. Approximately 30% of patients who develop acute hepatitis C recover spontaneously, signaled by improved symptoms, normalized liver-related chemistries, loss of HCV RNA from serum, and the development of HCV antibody. Cirrhosis rates become significant after 20 years of HCV infection. Haemodialysis is a process that uses a man-made membrane (dialyzer) to clear wastes such as urea from the blood, restore the proper balance of electrolytes in the blood and eliminate extra fluid from the body. Vascular calcification is common in patients with advanced haemodialysis and is associated with poorer outcomes. Objectives: The aim was to evaluate the possible impact of chronic HCV infection on coronary calcification in prevalent haemodialysis patients in Naval Forces hospital, Alexandria, Egypt and its relation to demographic data, haemodialysis data and other laboratory findings. Patietns and methods: This cross-sectional study was carried out on 60 patients with at least one year duration on regular haemodialysis; 30 HCV negative prevalent haemodialysis patients and 30 HCV positive prevalent haemodialysis patients. Results: Our study revealed that HCV negative patients included 25 (83.3%) males and 5 (16.7%) females, their mean age was 51.67 ± 6.91 years. The mean haemodialysis duration was 7.5 ± 1.89 years. There were statistically a high significant difference between HCV negative prevalent haemodialysis patients and HCV positive prevalent haemodialysis patients regarding AST, significant differences regarding ALT and albumin and non-significant differences regarding bilirubin, prothrombin time, international normalized ratio, cholesterol and total glycerides. But, there were no significant differences between HCV negative prevalent haemodialysis patients and HCV positive prevalent haemodialysis patients regarding CKD-MBD parameters (including PO4 and iPTH), except for calcium which exhibited statistically a significant difference. Also, there were no significant differences between HCV negative prevalent haemodialysis patients and HCV positive prevalent haemodialysis patients regarding creatinine, sodium and potassium, significant differences regarding URR, C-reactive protein and a high significant difference regarding Ca score. In HCV negative prevalent haemodialysis patients, there were statistically significant correlations regarding dialysis duration and international normalized ratio and high significant correlations between Ca score and creatinine, AST and prothrombin time. In HCV positive prevalent haemodialysis patients, there were statistically significant correlations between Ca score and dialysis duration and creatinine. Other correlations were insignificant. There were non-significant relations between Ca score and gender and dialysis vascular access.   Conclusion: A very high incidence of vascular calcification was found in chronic haemodialysis patients in our study as compared to other studies. Vascular calcification is correlated with many risk factors and control of the modifiable risk factors can help to decrease prevalence of vascular calcification.