Hemodialysis paradox: Survey on the incidence rate of hepatocellular carcinoma in antihepatitis virus C-antibody-positive chronic hemodialysis patients

The prevalence of antihepatitis virus C (HCV) antibodies in chronic hemodia lysis (HD) patients is higher than in normal populations, and yet hepatocel lular carcinoma (HCC) is infrequent in chronic HD patients who an HCV antib ody positive. In this study, we investigated the characteristics of HCV-ant ibody-positive patients with HCC on chronic HD. A total of 6,366 cases of H CV-antibody-positive patients on chronic HD therapy was analyzed on the bas is of answers to questionnaires on the incidence rate of HCC in 314 Japanes e dialysis institutions. HCC was a complication in 114 of 6,222 (1.8%) HCV- antibody-positive patients, and cirrhosis was a complication in 536 of 6,24 2 (8.6%). The incidence rate of both complications was significantly higher in males than in females, and the incidence rate in the chronic IID patien ts was much lower than in normal populations. Specific immunological status in patients on chronic HD therapy may be an important kev for preventing t he progression of chronic HCV hepatitis. However, further research is neede d because this study was preliminary and excluded the type of HCV virus, pa thological findings, and laboratory data.