Viral hepatitis and proteinuria in an area endemic for hepatitis B and C infections: another chain of link?

J Intern Med. 2006 Sep;260(3):255-62. doi: 10.1111/j.1365-2796.2006.01686.x.


Background and objectives: Virus hepatitis may lead to nephropathy as one of its multiple extrahepatic manifestations. Proteinuria by dipstick, a simple test in practice, is a useful and cardinal sign of underlying renal abnormalities. The aim of this study was to elucidate the impact of hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infections on the occurrence of proteinuria amongst adults.

Design and setting: A prospective, cross-sectional, community-based study was conducted in an HBV/HCV endemic area of southern Taiwan. Eligible subjects aged 40-65 years (n=9934) underwent testing of hepatitis B surface antigen (HBsAg), HCV antibody (anti-HCV) and other related biochemical profiles. Urinalysis with repeated dipstick for proteinuria detection was performed.

Results: Anti-HCV-positive rate amongst proteinuria subjects was significantly higher than nonproteinuria subjects (9.6% vs. 6.2%, P<0.001). By contrast, HBsAg-positive rate did not differ between subjects with and without proteinuria (13.0% vs. 13.8%, P=0.57). Prevalence of proteinuria amongst anti-HCV-positive subjects (10.2%) was significantly higher than that in HBsAg-positive subjects (6.4%, P=0.004) and in HBsAg-negative or anti-HCV-negative subjects (7.0%, P=0.004). The difference persisted even after excluding diabetics. Multivariate logistic regression analyses showed that diabetes was the most important significant factor associated with proteinuria, followed by hypertension, anti-HCV seropositivity, body mass index, age and triglyceride levels.

Conclusion: We demonstrated the significant association between proteinuria and HCV, but not HBV, infection in this HBV/HCV-endemic area.

MeSH terms

  • Adult
  • Aged
  • Endemic Diseases
  • Epidemiologic Methods
  • Female
  • Hepacivirus*
  • Hepatitis B / urine*
  • Hepatitis B virus*
  • Hepatitis C / urine*
  • Humans
  • Male
  • Middle Aged
  • Proteinuria / urine*
  • Proteinuria / virology
  • Taiwan