Bacteremia in hemodialysis patients with Hepatitis C

Puja Chebrolu, Rhonda E. Colombo, Stephanie Baer, T. Ryan Gallaher, Sara Atwater, Mufaddal Kheda, N. Stanley Nahman*, Kristina W. Kintziger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: Hepatitis C virus (HCV) infection and bacteremia are common comorbidities in hemodialysis patients. A specific relationship between HCV infection and bacteremia has not been defined; however, there is evidence of immune compromise in both HCV-infected and uremic patients, suggesting that this group may be at higher risk for infection. Methods: We investigated risk factors and mortality associated with bacteremia in HCV-infected hemodialysis patients from the United States Renal Data System. Results: During the 4-year study period, HCV was present in 2.1% of 355,084 patients initiating hemodialysis. When compared with the total population, the rate of bacteremia was significantly higher in patients with HCV (38.3% versus 21.8%). The adjusted relative risk (RR) for bacteremia was higher in HCV versus all patients (relative risk, 95% confidence interval [CI]) in the presence of methicillin-resistant Staphylococcus aureus infection (2.64, CI: 2.58-2.70 versus 2.32, CI: 2.27-2.38), HIV (1.93, CI: 1.85-2.02 versus 1.86, CI: 1.77-1.95) urinary tract infection (1.79, CI: 1.77, 1.82 versus 1.64, CI: 1.61-1.67) and cirrhosis (1.49, CI: 1.45-1.54 versus 1.29, CI: 1.25-1.34). The hazard ratio (95% CI) for death was higher in HCV versus all patients at 1.69 (CI: 1.58-1.81) versus 1.54 (CI: 1.53-1.56). Conclusions: These data indicate that several clinical covariates increase the risk of bacteremia in hemodialysis patients, with the magnitude of that risk being further increased by HCV infection. Improving outcomes in HCV-infected hemodialysis patients will likely be dependent on aggressive diagnosis and treatment of both HCV and bacteremia.

Original languageEnglish
Pages (from-to)217-221
Number of pages5
JournalAmerican Journal of the Medical Sciences
Issue number3
StatePublished - 10 Mar 2015


  • Bacteremia
  • Hemodialysis
  • Hepatitis C


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