PMID- 30123002
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220318
IS  - 1179-1349 (Print)
IS  - 1179-1349 (Electronic)
IS  - 1179-1349 (Linking)
VI  - 10
DP  - 2018
TI  - Hepatitis C infection substantially reduces survival of alcohol-dependent 
      patients.
PG  - 897-905
LID - 10.2147/CLEP.S162308 [doi]
AB  - BACKGROUND: Heavy alcohol use is associated with life-threatening complications 
      including progressive liver disease. We aimed to analyze the impact of hepatitis 
      C virus (HCV) infection on survival and liver-related death in alcohol-dependent 
      patients. PATIENTS AND METHODS: This is a longitudinal study in patients seeking 
      treatment of alcohol abuse between 2000 and 2010. Information on alcohol use 
      characteristics, alcoholic liver disease, and HCV infection were obtained at 
      entry. Cumulated mortality and causes of death were ascertained through clinical 
      records and death registry. RESULTS: A total of 819 patients (81.6% men) 
      underwent ethanol detoxification; age was 44 (inter-quartile range [IQR] 38-51) 
      years; the duration of heavy alcohol use was 14 (IQR 6-24) years; and the alcohol 
      consumption was 190 (IQR 120-250) g/day. The prevalence of HCV infection was 
      15.8%. There were 129 (16.9%) deaths during 5,117 persons-year (p-y) of follow-up 
      (median follow-up 6.4 [IQR 4.3-9.2] years); 31 (24.6%) deaths were observed among 
      the HCV-positive patients, and 98 (15.4%) deaths were observed among the 
      HCV-negative patients. The mortality rate was significantly (P=0.03) higher among 
      the HCV-positive patients (3.84x100 p-y; 95% confidence interval [CI]: 2.70, 
      5.46) than among the HCV-negative patients (2.27x100 p-y; 95% CI: 1.86, 2.77). 
      Survival times for the HCV infected patients were 34% shorter (time ratio 
      relative to HCV negative: 0.66; 95% CI: 0.51, 0.86). The main causes of death in 
      the HCV-positive and -negative patients were liver-related mortality (48.4%) and 
      neoplasia (22.4%), respectively. The liver-related mortality was significantly 
      higher among the HCV-positive patients (adjusted sub-distribution hazard ratio 
      [asHR] 3.65; 95% CI: 1.72, 7.78; P=0.001). CONCLUSION: HCV infection compromises 
      the survival of patients with alcohol abuse/dependence. The new direct antiviral 
      agents for the treatment of HCV infection may result in better clinical outcomes.
FAU - Muga, Roberto
AU  - Muga R
AD  - Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 
      Universitat Autonoma de Barcelona, Badalona, Spain, 
      rmuga.germanstrias@gencat.cat.
FAU - Sanvisens, Arantza
AU  - Sanvisens A
AD  - Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 
      Universitat Autonoma de Barcelona, Badalona, Spain, 
      rmuga.germanstrias@gencat.cat.
FAU - Jarrin, Inmaculada
AU  - Jarrin I
AD  - National Center of Epidemiology, Institute of Health Carlos III, Madrid, Spain.
FAU - Fuster, Daniel
AU  - Fuster D
AD  - Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 
      Universitat Autonoma de Barcelona, Badalona, Spain, 
      rmuga.germanstrias@gencat.cat.
FAU - Bolao, Ferran
AU  - Bolao F
AD  - Department of Internal Medicine, Hospital Universitari de Bellvitge-IDIBELL, 
      Universitat de Barcelona, L'Hospitalet de Llobregat, Spain.
FAU - Tor, Jordi
AU  - Tor J
AD  - Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, 
      Universitat Autonoma de Barcelona, Badalona, Spain, 
      rmuga.germanstrias@gencat.cat.
FAU - Munoz, Alvaro
AU  - Munoz A
AD  - Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public 
      Health, Baltimore, MD, USA.
LA  - eng
PT  - Journal Article
DEP - 20180801
PL  - New Zealand
TA  - Clin Epidemiol
JT  - Clinical epidemiology
JID - 101531700
PMC - PMC6078082
OTO - NOTNLM
OT  - alcohol use disorder
OT  - hepatitis C virus
OT  - liver disease
OT  - mortality
OT  - survival
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2018/08/21 06:00
MHDA- 2018/08/21 06:01
PMCR- 2018/08/01
CRDT- 2018/08/21 06:00
PHST- 2018/08/21 06:00 [entrez]
PHST- 2018/08/21 06:00 [pubmed]
PHST- 2018/08/21 06:01 [medline]
PHST- 2018/08/01 00:00 [pmc-release]
AID - clep-10-897 [pii]
AID - 10.2147/CLEP.S162308 [doi]
PST - epublish
SO  - Clin Epidemiol. 2018 Aug 1;10:897-905. doi: 10.2147/CLEP.S162308. eCollection 
      2018.