Infection With Hepatitis C Virus Genotype 3 is an Independent Risk Factor for End-stage Liver Disease, Hepatocellular Carcinoma, and Liver-related Death

McMahon, Brian J; Bruden, Dana; Townshend-Bulson, Lisa; Simons, Brenna; Spradling, Phillip; Livingston, Stephen; Gove, James; Hewitt, Annette; Plotnik, Julia; Homan, Chriss; Espera, Hannah; Negus, Susan; Snowball, Mary; Barbour, Youssef; Bruce, Michael; Gounder, Prabhu

doi:10.1016/j.cgh.2016.10.012

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Infection With Hepatitis C Virus Genotype 3 is an Independent Risk Factor for End-stage Liver Disease, Hepatocellular Carcinoma, and Liver-related Death

3 2017
By McMahon, Brian J ; Bruden, Dana ; Townshend-Bulson, Lisa ; ...
http://dx.doi.org/10.1016/j.cgh.2016.10.012
Source: Clin Gastroenterol Hepatol. 15(3):431-437.e2

[PDF-89.77 KB]

English

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Details:

Alternative Title:

Clin Gastroenterol Hepatol
Personal Author:

McMahon, Brian J ; Bruden, Dana ; Townshend-Bulson, Lisa ; Simons, Brenna ; Spradling, Phillip ; ... More +

McMahon, Brian J ; Bruden, Dana ; Townshend-Bulson, Lisa ; Simons, Brenna ; Spradling, Phillip ; Livingston, Stephen ; Gove, James ; Hewitt, Annette ; Plotnik, Julia ; Homan, Chriss ; Espera, Hannah ; Negus, Susan ; Snowball, Mary ; Barbour, Youssef ; Bruce, Michael ; Gounder, Prabhu Less -
Description:

Background & Aims

Few studies have examined factors associated with disease progression in hepatitis C virus (HCV) infection. We examined the association of 11 risk factors with adverse outcomes in a population-based prospective cohort observational study of Alaska Native/American Indian persons with chronic HCV infection.

Methods

We collected data from a population-based cohort study of liver-related adverse outcomes of infection in American Indian/Alaska Native persons with chronic HCV living in Alaska, recruited from 1995 through 2012. We calculated adjusted hazard ratios (aHR) and 95% CIs for end-stage liver disease (ESLD; presence of ascites, esophageal varices, hepatic encephalopathy, or coagulopathy), hepatocellular carcinoma (HCC), and liver-related death using a Cox proportional hazards model.

Results

We enrolled 1080 participants followed for 11,171 person-years (mean, 10.3 years); 66%, 19%, and 14% were infected with HCV genotypes 1, 2, and 3, respectively. On multivariate analysis, persons infected with HCV genotype 3 had a significantly increased risk of developing all 3 adverse outcomes. Their aHR for ESLD was 2.1 (95% CI, 1.5–3.0), aHR for HCC was 3.1 (95% CI, 1.4–6.6), and aHR for liver-related death was 2.4 (95% CI, 1.5–4.0) compared to genotype 1. Heavy alcohol use was an age-adjusted risk factor for ESLD (aHR, 2.2; 95% CI, 1.6–3.2), and liver-related death (aHR: 2.9; 95% CI, 1.8–4.6). Obesity was a risk factor for ESLD (aHR, 1.4; 95% CI, 1.0–1.9, and diabetes was a risk factor for ESLD (aHR, 1.5; 95% CI, 1.1–2.2). Male sex was a risk factor for HCC (aHR, 3.6; 95% CI, 1.6–8.2).

Conclusions

In a population-based cohort study of American Indian/Alaska Native persons with chronic HCV infection, we found those infected with HCV genotype 3 to be at high risk for ESLD, HCC, and liver-related death.
Keywords:

[+]

Adult AK-HEPC Alaska Alaska Natives American Indian/ Alaska Native Carcinoma, Hepatocellular Disease Progression End Stage Liver Disease Female Genotype Hepacivirus Hepatitis C, Chronic Hepatitis C Outcome Humans Indians, North American Liver Cancer Risk Male Middle Aged Prospective Studies Risk Factors Survival Analysis
Source:

Clin Gastroenterol Hepatol. 15(3):431-437.e2
Pubmed ID:

27765729
Pubmed Central ID:

PMC5316337
Document Type:

Journal Article
Funding:

P20 GM103395/GM/NIGMS NIH HHSUnited States/ ; T32 HS000046/HS/AHRQ HHSUnited States/ ; U01 PS001097/PS/NCHHSTP CDC HHSUnited States/

P20 GM103395/GM/NIGMS NIH HHSUnited States/ ; T32 HS000046/HS/AHRQ HHSUnited States/ ; U01 PS001097/PS/NCHHSTP CDC HHSUnited States/ Less -
Volume:

15
Issue:

3
Collection(s):

CDC Public Access
Main Document Checksum:

[+]

urn:sha256:2bdced625f2793aa2c482d002db1c84f1d4beb22ff0d60ccc97b04f1fed99133
Download URL:

https://stacks.cdc.gov/view/cdc/44267/cdc_44267_DS1.pdf
File Type:

	NIHMS823649-supplement-supplement_1.pdf	pdf
	nihms823649.nxml	xml

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