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.


Subject:
[+]
Adult Alaska Natives Carcinoma, Hepatocellular Disease Progression End Stage Liver Disease Female Genotype Hepacivirus Hepatitis C, Chronic Humans Indians, North American 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 HHS/United States ; T32 HS000046/HS/AHRQ HHS/United States ; U01 PS001097/PS/NCHHSTP CDC HHS/United States
P20 GM103395/GM/NIGMS NIH HHS/United States ; T32 HS000046/HS/AHRQ HHS/United States ; U01 PS001097/PS/NCHHSTP CDC HHS/United States Less -
Place as Subject:
Alaska
Collection(s):
Arctic Investigations Program CDC Public Access
Main Document Checksum:
[+]
urn:sha256:2bdced625f2793aa2c482d002db1c84f1d4beb22ff0d60ccc97b04f1fed99133
Download URL:
https://stacks.cdc.gov/view/cdc/44267/cdc_44267_DS1.pdf
File Type:

Supporting Files

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

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