Clinical—Liver, Pancreas, and Biliary TractAdverse Outcomes in Alaska Natives Who Recovered From or Have Chronic Hepatitis C Infection
Section snippets
Recruitment and Follow-up
Since 1992, HCV serologic testing has been available to all AN persons at the Alaska Native Medical Center in Anchorage. Alaska has a population of 660,000 persons of whom approximately 130,000 (20%) are AN persons, who are eligible to receive health care through the AN health system, a statewide tribally operated health delivery system consisting of rural health clinics, regional hospitals, and a tertiary medical center, the Alaska Native Medical Center. The characteristics of the population
Results
Among 1590 anti–HCV-positive persons, 960 (60%) consented for long-term follow-up of HCV outcomes (Figure 1). No significant differences were found in age, sex, or residence in persons who consented and persons who did not consent. These 960 persons were followed prospectively for a mean of 7.2 years and retrospectively for a mean of 12.1 years. The characteristics of the entire cohort and persons who had chronic HCV infection compared with persons who recovered are shown in Table 1. For the
Discussion
With the use of both prospective and retrospective data from a long-term, population-based cohort of AN persons with HCV infection, our study showed that alcohol consumption >50 g/d at the time of enrollment was the greatest predictor of adverse liver outcome, significantly higher than HCV infection alone. A history of heavy alcohol use was associated with the highest incidence of LRD and ESLD, regardless of whether persons were chronically infected or had recovered from HCV. Our survival
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Cited by (37)
The contribution of alcohol use disorder to decompensated cirrhosis among people with hepatitis C: An international study
2018, Journal of HepatologyCitation Excerpt :Defining an individual’s risk of liver disease progression is often difficult, due to the non-linear nature of disease progression, and fluctuating lifestyle co-factors.31 However, heavy alcohol use (>50 g/d) has been shown to be associated with end-stage liver disease diagnosis and liver-related mortality, independent of chronic HCV infection or viral eradication by therapy.32 Given its significant impact, where needed, effects of alcohol use disorder should be mitigated to lower the risk of liver disease progression among people with HCV infection.
Prevalence and correlates of hepatitis C virus–associated inflammatory arthritis in a population-based cohort
2017, Seminars in Arthritis and RheumatismInfection With Hepatitis C Virus Genotype 3 Is an Independent Risk Factor for End-Stage Liver Disease, Hepatocellular Carcinoma, and Liver-Related Death
2017, Clinical Gastroenterology and HepatologyCitation Excerpt :All participants provided written informed consent. At the time of AK-HEPC study enrollment, study nurses conducted an extensive interview of each participant to obtain information on risk factors and demographic data that were reviewed in our previous publication.5 Information was obtained directly from the HCV registry, by chart review including International Classification of Diseases, 9th revision (ICD-9) liver-related diagnosis, and review of the State of Alaska Death Tapes from 1995 through 2012.
Association of Hepatitis C Virus With Alcohol Use Among U.S. Adults: NHANES 2003–2010
2016, American Journal of Preventive MedicineCitation Excerpt :Complications associated with chronic HCV infection include cirrhosis and hepatocellular carcinoma, which are projected to increase substantially within the next decade and are leading causes for liver transplantation.6–10 Alcohol use has been identified as a primary predictor in the progression of those complications.11 Excessive alcohol use among individuals chronically infected with HCV was associated with an increased risk of all-cause and liver-related mortality compared with infected people without excessive alcohol use.12
Excess mortality rate associated with hepatitis C virus infection: A community-based cohort study in rural Egypt
2016, Journal of HepatologyCitation Excerpt :In contrast to participants with chronic HCV infection, those who cleared HCV infection had a similar all-cause mortality rate compared to those never infected in this study. This differs from reports from Western countries where injecting drug use is the major mode of HCV transmission and people who cleared HCV share the same lifestyle risks (drug overdose, suicide, murder, excessive alcohol consumption, HIV co-infection) as those who became chronically infected with HCV [8,12,14]. In Denmark, all-cause mortality of people who cleared HCV was significantly higher than that of never infected, except in a subgroup of individuals aged 40–69 years without injecting drug use, alcohol abuse and other comorbidities, implying that in the absence of high-risk behaviours there is little excess mortality in people who cleared HCV infection [14].
Natural history of hepatitis C
2014, Journal of HepatologyCitation Excerpt :The impact of ongoing alcohol use in anti-HCV positive, HCV RNA negative individuals remains important: McMahon et al. compared survival data from subjects that were chronically infected with those who recovered from HCV infection, stratified by alcohol use. No difference was discerned among heavy alcohol users in the incidence of liver related deaths or end stage liver disease in those with chronic HCV, compared with those recovered from HCV infection [16]. Treatment is indicated in patients who are deemed to develop chronic hepatitis.
Conflicts of interest The authors disclose no conflicts.
Funding Supported by the National Institutes of Health (grant AI 48214 and R01 AI 66209) and by the Alaska Native Tribal Health Consortium and the Arctic Investigations Program, CDC.