HEPATITIS C BURDEN IN PRE-DIALYSIS CHRONIC KIDNEY DISEASE: STAGE-DEPENDENT RISK AND CLINICAL IMPLICATIONS

Abstract

Hepatitis C virus (HCV) infection represents a significant comorbidity in chronic kidney disease (CKD) patients, yet its prevalence and clinical impact in pre-dialysis populations remain understudied, particularly in high-endemic regions. This cross-sectional study investigated HCV frequency among 220 pre-dialysis CKD patients at a tertiary care hospital in Karachi. Participants were screened via ELISA, with demographic, clinical, and laboratory data analyzed using SPSS v16. Chi-square and t-tests assessed associations between HCV status and CKD progression markers. HCV prevalence was 13.2% (n=29), with significantly higher detection in Stage 4 CKD (86.2% of positive cases, p<0.001). No HCV-positive cases occurred in Stages 2–3. Hypertension (55.2% vs. 45%, p=0.20) and diabetes (34.5% vs. 38.7%, p=0.41) showed no significant association with HCV status. Marginal links emerged with lower education levels (p=0.03), while blood transfusion (48.3% vs. 42.4%, p=0.34) and surgical history (31% vs. 28.3%, p=0.45) were non-significant risk factors. HCV disproportionately affects advanced pre-dialysis CKD patients, independent of traditional metabolic risk factors. Findings advocate for routine HCV screening in Stage 4 CKD populations and prompt antiviral therapy to potentially mitigate renal decline. Socioeconomic factors may influence infection risk, warranting targeted prevention strategies.