Introduction:

Epidemiological studies have reported that patients with chronic hepatitis C virus (HCV) infection may present alterations in bone mineral metabolism.

Objective:

To evaluate the relationship between HCV infection and mineral metabolism in patients with chronic kidney disease (CKD) undergoing hemodialysis.

Materials and Methods:

A cross-sectional, case-control study was conducted. The non-randomized sample included 1,213 patients with a positive HCV serological diagnosis (cases) and 2,933 patients with negative HCV serology (controls), of both sexes, aged 18-80 years. Serum biomarkers of mineral metabolism (PTH, vitamin D, calcium, phosphorus, magnesium, and iron), liver function tests, and serology for HAV, HBV, HIV, and syphilis were measured in fasting samples collected during the interdialysis period.

Results:

The mean age of the study population was 53.16 ± 15.45 years (95% CI: 52.69-53.64). Compared with controls, patients with HCV infection had significantly higher mean serum concentrations of sodium, phosphorus, magnesium, iron, ferritin, and parathyroid hormone; increased serum enzyme activities of AST, ALT, and ALP; and higher FIB-4 and APRI indices (Student’s t-test, p < 0.01, α = 0.05). The frequency of severe secondary hyperparathyroidism (intact PTH > 600 pg/mL) and vitamin D insufficiency was also significantly greater in the HCV group (544/1213 and 478/1213, respectively) compared with controls (834/2933 and 830/2933; p < 0.0001, Chi-square test, α = 0.05).

Conclusion:

In CKD patients on hemodialysis, HCV infection is associated with a higher prevalence of severe secondary hyperparathyroidism and vitamin D insufficiency, reflected by elevated intact PTH and reduced vitamin D levels.