Influence of alcohol on the progression of hepatitis C virus infection: a meta-analysis

S. Hutchinson, S. Bird, D.J. Goldberg

Research output: Contribution to journalArticle

132 Citations (Scopus)

Abstract

Background & Aims: A convincing, yet inconsistent, pattern has emerged that demonstrates increased progression of HCV-related liver disease with heavy alcohol use. The aim was to perform a meta-analysis to quantify the effect of alcohol on cirrhosis risk among persons infected with HCV. Methods: A meta-analysis of 20 articles, involving more than 15,000 HCV chronically infected persons, published between 1995 and 2004 was undertaken to explore the relationship between advanced liver disease and the consumption of alcohol. Results: The pooled relative risk of cirrhosis associated with heavy alcohol intake (defined in the range of at least 210–560 g per week) was 2.33 (95% confidence interval, 1.67–3.26) by the random effects model. The risk of HCV-related liver disease associated with heavy alcohol intake increased with severity of the outcome; the lowest (1.63; 95% confidence interval, 1.22–2.17) and highest (3.54; 2.14–5.85) pooled relative risk estimates were obtained for advanced fibrosis and decompensated cirrhosis, respectively. The regression effect of alcohol might, however, be underestimated in studies investigating the risk of HCV-related cirrhosis because they necessarily include patients undergoing liver biopsy and could therefore under-represent heavy alcohol users. Conclusions: The evidence overwhelmingly shows a worsened outcome for those with chronic HCV and concurrent alcohol use. Studies varied widely in their definition of significant alcohol intake, and so the true threshold above which alcohol accelerates HCV disease progression remains uncertain. Alcohol consumption should be minimized as much as possible in those who have chronic HCV until a safe threshold is more definitively determined.

LanguageEnglish
Pages1150-1159
Number of pages9
JournalClinical Gastroenterology and Hepatology
Volume3
DOIs
Publication statusPublished - 2005

Fingerprint

Virus Diseases
Hepacivirus
Meta-Analysis
Alcohols
Fibrosis
Liver Diseases
Alcohol Drinking
Confidence Intervals
Disease Progression
Biopsy
Liver

Keywords

  • CI
  • relative risk
  • RR
  • odds ratio;,
  • OR,
  • injecting drug user;
  • IDU
  • HIV
  • HCC, hepatocellular carcinoma
  • confidence interval

Cite this

@article{8ddee251f97d41588287f82c947d96cc,
title = "Influence of alcohol on the progression of hepatitis C virus infection: a meta-analysis",
abstract = "Background & Aims: A convincing, yet inconsistent, pattern has emerged that demonstrates increased progression of HCV-related liver disease with heavy alcohol use. The aim was to perform a meta-analysis to quantify the effect of alcohol on cirrhosis risk among persons infected with HCV. Methods: A meta-analysis of 20 articles, involving more than 15,000 HCV chronically infected persons, published between 1995 and 2004 was undertaken to explore the relationship between advanced liver disease and the consumption of alcohol. Results: The pooled relative risk of cirrhosis associated with heavy alcohol intake (defined in the range of at least 210–560 g per week) was 2.33 (95{\%} confidence interval, 1.67–3.26) by the random effects model. The risk of HCV-related liver disease associated with heavy alcohol intake increased with severity of the outcome; the lowest (1.63; 95{\%} confidence interval, 1.22–2.17) and highest (3.54; 2.14–5.85) pooled relative risk estimates were obtained for advanced fibrosis and decompensated cirrhosis, respectively. The regression effect of alcohol might, however, be underestimated in studies investigating the risk of HCV-related cirrhosis because they necessarily include patients undergoing liver biopsy and could therefore under-represent heavy alcohol users. Conclusions: The evidence overwhelmingly shows a worsened outcome for those with chronic HCV and concurrent alcohol use. Studies varied widely in their definition of significant alcohol intake, and so the true threshold above which alcohol accelerates HCV disease progression remains uncertain. Alcohol consumption should be minimized as much as possible in those who have chronic HCV until a safe threshold is more definitively determined.",
keywords = "CI, relative risk, RR, odds ratio;, , OR, , injecting drug user; , IDU, HIV, HCC, hepatocellular carcinoma, confidence interval",
author = "S. Hutchinson and S. Bird and D.J. Goldberg",
year = "2005",
doi = "10.1016/S1542-3565(05)00407-6",
language = "English",
volume = "3",
pages = "1150--1159",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",

}

Influence of alcohol on the progression of hepatitis C virus infection: a meta-analysis. / Hutchinson, S.; Bird, S.; Goldberg, D.J.

In: Clinical Gastroenterology and Hepatology, Vol. 3, 2005, p. 1150-1159.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Influence of alcohol on the progression of hepatitis C virus infection: a meta-analysis

AU - Hutchinson, S.

AU - Bird, S.

AU - Goldberg, D.J.

PY - 2005

Y1 - 2005

N2 - Background & Aims: A convincing, yet inconsistent, pattern has emerged that demonstrates increased progression of HCV-related liver disease with heavy alcohol use. The aim was to perform a meta-analysis to quantify the effect of alcohol on cirrhosis risk among persons infected with HCV. Methods: A meta-analysis of 20 articles, involving more than 15,000 HCV chronically infected persons, published between 1995 and 2004 was undertaken to explore the relationship between advanced liver disease and the consumption of alcohol. Results: The pooled relative risk of cirrhosis associated with heavy alcohol intake (defined in the range of at least 210–560 g per week) was 2.33 (95% confidence interval, 1.67–3.26) by the random effects model. The risk of HCV-related liver disease associated with heavy alcohol intake increased with severity of the outcome; the lowest (1.63; 95% confidence interval, 1.22–2.17) and highest (3.54; 2.14–5.85) pooled relative risk estimates were obtained for advanced fibrosis and decompensated cirrhosis, respectively. The regression effect of alcohol might, however, be underestimated in studies investigating the risk of HCV-related cirrhosis because they necessarily include patients undergoing liver biopsy and could therefore under-represent heavy alcohol users. Conclusions: The evidence overwhelmingly shows a worsened outcome for those with chronic HCV and concurrent alcohol use. Studies varied widely in their definition of significant alcohol intake, and so the true threshold above which alcohol accelerates HCV disease progression remains uncertain. Alcohol consumption should be minimized as much as possible in those who have chronic HCV until a safe threshold is more definitively determined.

AB - Background & Aims: A convincing, yet inconsistent, pattern has emerged that demonstrates increased progression of HCV-related liver disease with heavy alcohol use. The aim was to perform a meta-analysis to quantify the effect of alcohol on cirrhosis risk among persons infected with HCV. Methods: A meta-analysis of 20 articles, involving more than 15,000 HCV chronically infected persons, published between 1995 and 2004 was undertaken to explore the relationship between advanced liver disease and the consumption of alcohol. Results: The pooled relative risk of cirrhosis associated with heavy alcohol intake (defined in the range of at least 210–560 g per week) was 2.33 (95% confidence interval, 1.67–3.26) by the random effects model. The risk of HCV-related liver disease associated with heavy alcohol intake increased with severity of the outcome; the lowest (1.63; 95% confidence interval, 1.22–2.17) and highest (3.54; 2.14–5.85) pooled relative risk estimates were obtained for advanced fibrosis and decompensated cirrhosis, respectively. The regression effect of alcohol might, however, be underestimated in studies investigating the risk of HCV-related cirrhosis because they necessarily include patients undergoing liver biopsy and could therefore under-represent heavy alcohol users. Conclusions: The evidence overwhelmingly shows a worsened outcome for those with chronic HCV and concurrent alcohol use. Studies varied widely in their definition of significant alcohol intake, and so the true threshold above which alcohol accelerates HCV disease progression remains uncertain. Alcohol consumption should be minimized as much as possible in those who have chronic HCV until a safe threshold is more definitively determined.

KW - CI

KW - relative risk

KW - RR

KW - odds ratio;,

KW - OR,

KW - injecting drug user;

KW - IDU

KW - HIV

KW - HCC, hepatocellular carcinoma

KW - confidence interval

UR - http://dx.doi.org/10.1016/S1542-3565(05)00407-6

U2 - 10.1016/S1542-3565(05)00407-6

DO - 10.1016/S1542-3565(05)00407-6

M3 - Article

VL - 3

SP - 1150

EP - 1159

JO - Clinical Gastroenterology and Hepatology

T2 - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

ER -