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

Details

• Alternative Title:
  Clin Gastroenterol Hepatol
• Personal Author:
  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
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• 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:
  • Hepatitis C Outcome
  • AK-HEPC
  • liver cancer risk
  • American Indian/ Alaska Native
  • Adult
  • Alaska
  • Alaska Natives
  • Carcinoma, Hepatocellular
  • Disease Progression
  • End Stage Liver Disease
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• 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/
• Volume:
  15
• Issue:
  3
• Download URL:
  https://stacks.cdc.gov/view/cdc/44267/cdc_44267_DS1.pdf
• File Type:
  [PDF - 89.77 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2bdced625f2793aa2c482d002db1c84f1d4beb22ff0d60ccc97b04f1fed99133