Chronic kidney disease in isolated core antibody positive hepatitis B patients: Risk analysis from NHANES 2017-2020 study.

BACKGROUND

The association between isolated hepatitis B core antibody (HBcAb) positivity and chronic kidney disease (CKD) remains debated. While some studies suggest HBV infection increases CKD risk, others report inconclusive findings. This study evaluated the association between isolated HBcAb positivityand CKD in the U.S.

METHODS

Data from adult participants in the NHANES 2017-2020 pre-pandemic cycle were analyzed based on prespecified eligibility criteria. Participants were categorized into isolated HBcAb positive and non-infected groups. Weighted means and percentages described participant characteristics, while logistic regression models evaluated the association between isolated HBcAb positive and CKD. Multivariate logistic regression identified CKD risk factors among isolated HBcAb positive individuals.

RESULTS

Among 7,582 participants (7072 non- infected and 510 isolated HBcAb positive), CKD prevalence was higher in isolated HBcAb positive individuals (7.9 %vs. 5.2 %, P = 0.018). Unadjusted analyses showed isolated HBcAb positivity increased CKD risk (OR = 1.25, 95 % CI: 1.04-1.50, P = 0.019). However, adjusted analyses revealed an inverse association (OR = 0.76, 95 % CI: 0.60-0.98, P = 0.034). In isolated HBcAb positive individuals, older age (OR = 1.06, P = 0.017) and serum urea nitrogen (BUN) elevation (OR = 1.20, P = 0.001) were associated with higher CKD risk, while higher education lever reduced the risk (OR = 0.28, P = 0.030).

CONCLUSION

Although CKD prevalence was higher in isolated HBcAb positive patients, There was no positive association between isolated HBcAb positivity and CKD. Older age and elevated BUN levels were significantly associated with higher CKD risk, while elevated education lever reduced the risk. These findings highlight the needs for individualized monitoring and management of at-risk HBV-infected patients when offering antiviral therapy and monitoring after clinical cure of hepatitis B.