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Hepatitis C virus infection in alcoholic hepatitis: prevalence patterns and impact on in-hospital mortality
Ashwani K Singal1, Yong-Fang Kuo, Bhupinderjit S Anand
1Department of Internal Medicine, Division of Gastroenterology, Center for Aging, University of Texas Medical Branch, Galveston, Texas 55905, USA. ashwanisingal.com@gmail.com
Insights
Hepatitis C virus (HCV) infection is more common in alcoholic hepatitis (AH) patients. While in-hospital mortality for AH has decreased, HCV infection independently predicts higher mortality in these patients.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Alcoholic hepatitis (AH) and Hepatitis C virus (HCV) infection are leading causes of cirrhosis in the USA.
- Limited data exist on the prevalence and mortality trends of HCV in patients with AH.
Purpose of the Study:
- To assess the prevalence of HCV infection among patients diagnosed with AH.
- To evaluate the impact of HCV on in-hospital mortality within the AH patient cohort.
Main Methods:
- Utilized the Nationwide Inpatient Sample dataset from 1998-2007.
- Stratified AH patients based on HCV status and analyzed factors associated with HCV positivity and in-hospital mortality using multivariable logistic regression.
Main Results:
- HCV prevalence in AH patients increased from 3.6% in 1998 to 7.7% in 2007.
- In-hospital mortality for AH patients decreased by approximately 7% annually from 1998 to 2007.
- HCV infection was identified as an independent predictor of in-hospital mortality in AH patients (OR 1.29, P=0.0005).
Conclusions:
- Patients with AH exhibit a higher prevalence of HCV compared to the general population.
- Despite overall improvements in in-hospital mortality for AH, HCV infection remains a significant risk factor for increased mortality.
- Further research is needed to elucidate the interaction mechanisms between HCV and AH and to develop targeted treatment strategies for improved outcomes in co-infected patients.
Background:
Hepatitis C virus (HCV) infection and alcohol abuse are common causes of cirrhosis in the USA. There are limited data on HCV prevalence and mortality trends in patients with alcoholic hepatitis (AH).
Aim:
The present study was carried out to assess HCV prevalence and mortality in AH patients.
Methods:
Patients with a primary or a secondary discharge diagnosis of AH obtained from the Nationwide Inpatient Sample dataset (1998-2007) were stratified based on the presence of HCV. Factors associated with HCV positivity and in-hospital mortality were examined using multivariable logistic regression.
Results:
Of 76 957 719 admissions, 111 726 had AH (7240 were HCV positive). The prevalence of HCV in AH patients was 3.6% in 1998 and 7.7% in 2007. In-hospital mortality was 3.2% (6.3% in 1998 and 2.7% in 2007), with an ~7% annual decrease between 1998 and 2007. HCV was an independent predictor of in-hospital mortality after controlling for calendar year [odds ratio 1.29; 95% CI (1.12-1.49); P=0.0005].
Conclusion:
Patients with AH have a higher prevalence of HCV compared with the general population. Although in-hospital mortality in AH patients has improved, HCV infection predicts a higher mortality. Further studies are required to determine the mechanisms of interaction of HCV and AH and develop treatment strategies to improve outcome of HCV-infected AH patients.
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