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

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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 (https://doi.org/10.1136/jech.2011.142976j.17)

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Abstract

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.

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