TY - JOUR
T1 - Relative effects of heavy alcohol use and Hepatitis C in decompensated chronic liver disease in a hospital inpatient population
AU - Mankal, Pavan Kumar
AU - Abed, Jean
AU - Aristy, Jose David
AU - Munot, Khushboo
AU - Suneja, Upma
AU - Engelson, Ellen S.
AU - Kotler, Donald P.
N1 - Publisher Copyright:
© 2015 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Background: Heavy alcohol use has been hypothesized to accelerate disease progression to end-stage liver disease in patients with hepatitis C virus (HCV) infection. In this study, we estimated the relative influences of heavy alcohol use and HCV in decompensated chronic liver disease (CLD). Methods: Retrospectively, 904 patients with cirrhotic disease admitted to our hospitals during January 2010-December 2012 were identified based on ICD9 codes. A thorough chart review captured information on demographics, viral hepatitis status, alcohol use and progression of liver disease (i.e. decompensation). Decompensation was defined as the presence of ascites due to portal hypertension, bleeding esophageal varices, hepatic encephalopathy or hepatorenal syndrome. Heavy alcohol use was defined as a chart entry of greater than six daily units of alcohol or its equivalent. Results: 347 patients were included based on our selection criteria of documented heavy alcohol use (n=215; 62.0%), hepatitis titers (HCV: n=182; 52.5%) and radiological evidence of CLD with or without decompensation (decompensation: n=225; 64.8%). Independent of HCV infection, heavy alcohol use significantly increased the risk of decompensation (OR=1.75, 95% CI 1.11-2.75, p < 0.02) relative to no heavy alcohol use. No significance was seen with age, sex, race, HIV, viral hepatitis and moderate alcohol use for risk for decompensation. Additionally, dose-relationship regression analysis revealed that heavy, but not moderate alcohol use, resulted in a three-fold increase (p=0.013) in the risk of decompensation relative to abstinence. Conclusions: While both heavy alcohol use and HCV infection are associated with risk of developing CLD, our data suggest that heavy, but not moderate, alcohol consumption is associated with a greater risk for hepatic decompensation in patients with cirrhosis than does HCV infection.
AB - Background: Heavy alcohol use has been hypothesized to accelerate disease progression to end-stage liver disease in patients with hepatitis C virus (HCV) infection. In this study, we estimated the relative influences of heavy alcohol use and HCV in decompensated chronic liver disease (CLD). Methods: Retrospectively, 904 patients with cirrhotic disease admitted to our hospitals during January 2010-December 2012 were identified based on ICD9 codes. A thorough chart review captured information on demographics, viral hepatitis status, alcohol use and progression of liver disease (i.e. decompensation). Decompensation was defined as the presence of ascites due to portal hypertension, bleeding esophageal varices, hepatic encephalopathy or hepatorenal syndrome. Heavy alcohol use was defined as a chart entry of greater than six daily units of alcohol or its equivalent. Results: 347 patients were included based on our selection criteria of documented heavy alcohol use (n=215; 62.0%), hepatitis titers (HCV: n=182; 52.5%) and radiological evidence of CLD with or without decompensation (decompensation: n=225; 64.8%). Independent of HCV infection, heavy alcohol use significantly increased the risk of decompensation (OR=1.75, 95% CI 1.11-2.75, p < 0.02) relative to no heavy alcohol use. No significance was seen with age, sex, race, HIV, viral hepatitis and moderate alcohol use for risk for decompensation. Additionally, dose-relationship regression analysis revealed that heavy, but not moderate alcohol use, resulted in a three-fold increase (p=0.013) in the risk of decompensation relative to abstinence. Conclusions: While both heavy alcohol use and HCV infection are associated with risk of developing CLD, our data suggest that heavy, but not moderate, alcohol consumption is associated with a greater risk for hepatic decompensation in patients with cirrhosis than does HCV infection.
KW - Alcohol
KW - Ascites
KW - Cirrhosis
KW - End stage liver disease
KW - Varices
UR - http://www.scopus.com/inward/record.url?scp=84923338567&partnerID=8YFLogxK
U2 - 10.3109/00952990.2014.964358
DO - 10.3109/00952990.2014.964358
M3 - Article
C2 - 25320839
AN - SCOPUS:84923338567
SN - 0095-2990
VL - 41
SP - 177
EP - 182
JO - American Journal of Drug and Alcohol Abuse
JF - American Journal of Drug and Alcohol Abuse
IS - 2
ER -