Hep C and alcohol on liver-related morbidity and mortality in Glasgow’s injecting drug user

Hep C and alcohol on liver-related morbidity and mortality in Glasgow’s injecting drug user

This month's issue of the Journal of Viral Hepatitis investigates the influence of hepatitis C and alcohol on liver-related morbidity and mortality in Glasgow’s injecting drug user population.

Infection with the hepatitis C virus (HCV) is associated with the development of severe liver disease, but cofactors – namely alcohol abuse – in Scotland’s HCV-positive population complicate estimation of the unique contribution of HCV.

Dr McDonald and colleagues from the United Kingdom compared the risk of hospital admission/death for a liver-related cause in a large cohort of Glasgow’s injecting drug users testing HCV-positive with injecting drug users testing HCV negative.
HCV positivity is associated with an increased risk of a liver-related outcome
Journal of Viral Hepatitis

Data for 6566 current/former injecting drug users 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.

The research team found that 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 injecting drug users with no prior alcohol-related hospitalization who tested positive, compared with those who tested anti-HCV negative, but not for those injecting drug users with a prior alcohol admission.

Dr McDonald's team concluded, "There was little evidence for an increased risk of hospitalization/death for an exclusively nonalcoholic liver condition for those testing positive, after adjustment for previous alcohol-related admission."

"Within Glasgow’s injecting drug user population, HCV positivity is associated with an increased risk of a liver-related outcome."

"However, this is not observed for those injecting drug users whose problem alcohol use already increases their risk."

J Viral Hep 2011: 18(4): e126–e133


14 April 2011