domingo, 20 de noviembre de 2016

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

2016 Oct 17. pii: S1542-3565(16)30929-6. doi: 10.1016/j.cgh.2016.10.012. [Epub ahead of print]

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

McMahon BJ1, Bruden D2, Townshend-Bulson L3, Simons B3, Spradling P4, Livingston S3, Gove J3, Hewitt A3, Plotnik J3, Homan C3, Espera H3, Negus S3, Snowball M3, Barbour Y3, Bruce M2, Gounder P2.

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Abstract

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.