Background:  The effect of co-morbid medical and psychiatric conditions and substance use upon mortality in the hepatitis C virus (HCV) and HCV/HIV-co-infected persons on dialysis is unknown.

Methods:  We identified HCV infected subjects in the USRDS using ICD-9 codes. Medical and psychiatric comorbidities including HIV, and drug and alcohol use diagnoses were also extracted using ICD-9 codes. Logistic regression was used to determine the predictors of mortality.

Results:  We identified 5310 HCV-infected and 427 HCV/HIV-co-infected subjects. The HCV/HIV-co-infected subjects were younger, more likely to be male and black and to have a lower body mass index. In univariable analysis in the HCV-mono-infected subjects, increasing age, coronary artery disease, stroke, peripheral vascular disease, diabetes, cirrhosis, wasting, cancer, and pneumonia were associated with a higher mortality, while black race was associated with a lower mortality. In the HCV/HIV-co-infected subjects, only stroke, cirrhosis, wasting, and smoking were associated with higher mortality, while black race was associated with lower mortality (Table 1). In multivariable analysis in the HCV-mono-infected subjects, increasing age, coronary artery disease, stroke, diabetes, cirrhosis, wasting, cancer, and pneumonia were associated with a higher risk of mortality while black race was associated with a lower risk of mortality. The only factors significantly associated with mortality in the HCV/HIV-co-infected subjects in the multivariable analysis were cirrhosis and wasting (Table 2).

Conclusions:  The predictors of mortality differ in HCV-mono-infected and HCV/HIV-co-infected persons on dialysis. Targeted interventions in these populations should be studied to determine whether survival can be improved in these groups.