Effect of Hepatitis C Virus Infection on Liver Function, T Cell Immunity, and Mortality Risk in Maintenance Hemodialysis Patients

Ning Zhang^1,#, Hua Liu^2,#, Syleenah Molebogeng Moloto³, Jian Hu¹, Jie Zheng⁴, Yingli He⁵, Xiaoqin Wang¹

1. Department of Clinical Laboratory, The First Affiliated Hospital of Xi’an Jiaotong University, 277# West Yanta Road, Xi’an, 710061, Shaanxi Province, China
2. Department of Blood Purification, The First Affiliated Hospital of Xi’an Jiaotong University, 277# West Yanta Road, Xi’an, 710061, Shaanxi Province, China
3. Health Science Center, Xi’an Jiaotong University, 76# West Yanta Road, Xi’an, 710061, Shaanxi Province, China
4. Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, 277# West Yanta Road, Xi’an, 710061, Shaanxi Province, China
5. Department of Infectious Diseases, The First Affiliated Hospital of Xi’an Jiaotong University, 277# West Yanta Road, Xi’an, 710061, Shaanxi Province, China

Both authors are co-first authors and have contributed equally to this work.

*Corresponding Authors: Yingli He; Email: heyingli2000@xjtu.edu.cn; Xiaoqin Wang; Email: wxq1493722680@xjtufh.edu.cn

Abstract
Objective
This retrospective study explored the clinical impact of hepatitis C virus (HCV) infection in maintenance hemodialysis (MHD) patients through comprehensive analysis of liver/renal function parameters, cellular immunity profiles, and long-term survival outcomes.
Methods
The study enrolled 28 HCV-infected MHD patients (MHD-HCV group), 28 HCV-negative MHD patients (MHD group), and 21 healthy controls (NC group) retrospectively. Liver and renal functions, lymphocyte subset analysis, and interleukin-10 (IL-10) levels were assessed. Overall survival at a median follow-up of 4 years was compared between the MHD-HCV and MHD groups.
Results
Biochemical analysis demonstrated significantly elevated liver enzymes in the MHD-HCV group compared to MHD group, with mean alanine aminotransferase (ALT) levels of 26.6 ± 18.6 vs. 10.1 ± 7.1U/L (P < 0.001) and aspartate aminotransferase (AST) levels of 20.0 ± 9.0 vs. 11.8 ± 5.5U/L (P = 0.001).Furthermore, the MHD-HCV group had elevated total bile acid (7.70 ± 7.17 vs. 3.44 ± 1.75, P = 0.007), total protein (67.9 ± 5.2 vs. 63.9 ± 5.6, P = 0.012), globulin (31.1 ± 5.9 vs. 26.5 ± 3.6, P = 0.003). Immunological profiling revealed significant upregulation of both regulatory T cells (Tregs: 4.48 ± 2.94 vs. 2.48 ± 1.81, P < 0.001) and interleukin-10 (IL-10: 78.7 ± 45.1 vs. 34.2 ± 15.2, P < 0.001).The patients in the MHD-HCV group had higher mortality risk compared with those in the MHD group (χ2=4.383, P = 0.036).
Conclusion
HCV infection in MHD patients leads to non-negligible liver dysfunction, elevated Tregs and IL-10, as well as higher mortality.

Keywords: Hepatitis C virus; maintenance hemodialysis; liver function; regulatory T cells; interleukin-10.