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The influence of hepatitis C and alcohol on liver-related morbidity and mortality in Glasgow

McDonald, S. and Hutchinson, S. and Mills, P. and Bird, S. and Cameron, S. and Dillon, J. and Goldberg, D. (2011) The influence of hepatitis C and alcohol on liver-related morbidity and mortality in Glasgow. Journal of Epidemiology and Community Health, 65 (Supple). A271-A271. ISSN 0143-005X

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Presented as part of poster session 2: chronic disease. This presesentation looks at infection with the hepatitis C virus (HCV) is associated with the development of severe liver disease, but cofactors – namely alcohol abuse – in Scotlands HCV-positive population complicate estimation of the unique contribution of HCV. We compared the risk of hospital admission/death for a liver-related cause in a large cohort of Glasgow's injecting drug users (IDUs) testing HCV-positive, with IDUs testing HCV-negative. Data for 6566 current/former IDUs who had been tested for anti-HCV and/or HCV RNA in Greater Glasgow health board between 1993 and 2007 were linked to the national hospitalisation database and deaths registry to identify all admissions and deaths from a liver-related condition. RRs were estimated using Cox regression for recurrent events. The risk of hospitalisation/death from a liver-related or an alcoholic liver-related condition following HCV testing was greater for those IDUs with no prior alcohol-related hospitalisation who tested positive [adjusted hazard ratio (HR) = 3.2, 95% CI 1.5 to 6.7; 4.9, 95% CI 1.8 to 13.1, respectively], compared with those who tested anti-HCV negative, but not for those IDUs with a prior alcohol admission (HR=0.8, 95% CI 0.4 to 1.5; 0.8, 95% CI 0.4 to 1.6). There was little evidence for an increased risk of hospitalisation/death for an exclusively non-alcoholic liver condition for those testing positive (HR=1.5, 95% CI 0.8 to 2.7), after adjustment for previous alcohol-related admission. Within Glasgow's IDU population, HCV positivity is associated with an increased risk of a liver-related outcome, but this is not observed for those IDUs whose problem alcohol use already increases their risk.