The influence of hepatitis C and alcohol on liver-related morbidity and mortality in Glasgow's injecting drug user population

S.A. McDonald, Sharon Hutchinson, P.R. Mills, Bird S.M., S. Cameron, J.F. Dillon, D.J. Goldberg

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Infection with the hepatitis C virus (HCV) is associated with the development of severe liver disease, but cofactors – namely alcohol abuse – in Scotlands HCV-positive population complicate estimation of the unique contribution of HCV. We compared the risk of hospital admission/death for a liver-related cause in a large cohort of Glasgows injecting drug users (IDUs) testing HCV-positive with IDUs testing HCV negative. Data for 6566 current/former IDUs who had been
tested for anti-HCV and/or HCV RNA by polymerase chain reaction in Greater Glasgow health board between 1993 and 2007 were linked to the national hospitalization database and deaths registry to identify all admissions and deaths from a liver-related condition. Relative risks were estimated using Cox proportional hazards regression for recurrent events. Time at risk was censored at 2 years following an HCV test to address bias owing to unobserved seroconversion. The risk of hospitalization/death from a liver-related or an alcoholic liver-related condition following HCV testing was greater for those IDUs with no prior alcohol-related hospitalization who tested positive [adjusted hazard ratio (HR) = 3.2, 95% CI:1.5–6.7; 4.9, 95% CI: 1.8–13.1, respectively], compared with those who tested anti-HCV negative, but not for those IDUs with a prior alcohol admission (HR = 0.8, 95% CI: 0.4–1.5; 0.8, 95% CI: 0.4–1.6). There was little evidence for an increased risk of hospitalization/death for an exclusively nonalcoholic liver condition for those testing positive (HR = 1.5,
95% CI: 0.8–2.7), after adjustment for previous alcohol related
admission. Within Glasgows IDU population, HCV positivity is associated with an increased risk of a liver-related outcome, but this is not observed for those IDUs whose problem alcohol use already increases their risk
LanguageEnglish
Pagese104-e133
Number of pages7
JournalJournal of Viral Hepatitis
Volume18
Issue number4
Early online date22 Oct 2010
DOIs
Publication statusPublished - Apr 2011

Fingerprint

Hepatitis C
Drug Users
Hepacivirus
Alcohols
Morbidity
Mortality
Liver
Population
Hospitalization
Scotland
DNA-Directed RNA Polymerases
Alcoholism
Registries
Liver Diseases
Databases
Polymerase Chain Reaction

Keywords

  • alcohol
  • hospital admissions
  • liver disease
  • drug users
  • hepatitis C
  • injecting

Cite this

McDonald, S. A., Hutchinson, S., Mills, P. R., S.M., B., Cameron, S., Dillon, J. F., & Goldberg, D. J. (2011). The influence of hepatitis C and alcohol on liver-related morbidity and mortality in Glasgow's injecting drug user population. Journal of Viral Hepatitis, 18(4), e104-e133. https://doi.org/10.1111/j.1365-2893.2010.01380.x
McDonald, S.A. ; Hutchinson, Sharon ; Mills, P.R. ; S.M., Bird ; Cameron, S. ; Dillon, J.F. ; Goldberg, D.J. / The influence of hepatitis C and alcohol on liver-related morbidity and mortality in Glasgow's injecting drug user population. In: Journal of Viral Hepatitis. 2011 ; Vol. 18, No. 4. pp. e104-e133.
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The influence of hepatitis C and alcohol on liver-related morbidity and mortality in Glasgow's injecting drug user population. / McDonald, S.A.; Hutchinson, Sharon; Mills, P.R.; S.M., Bird; Cameron, S.; Dillon, J.F.; Goldberg, D.J.

In: Journal of Viral Hepatitis, Vol. 18, No. 4, 04.2011, p. e104-e133.

Research output: Contribution to journalArticle

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