Comorbidities associated with the increasing burden of hepatitis C infection

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http://www3.interscience.wiley.com/journal/123342784/abstract

Liver International

Volume 30 Issue 7, Pages 1012 - 1018

Published Online: 8 Apr 2010

© 2010 Wiley & Sons A/S

CLINICAL STUDIES

Comorbidities associated with the increasing burden of hepatitis C infection

Basseri 1 , Yamini 1 , Grace Chee 1 , Pharm D. Pedram Enayati 1 ,

Tram Tran 1 and Fred Poordad 1

1 Hepatology Section, Division of Gastroenterology, Cedars-Sinai Medical

Center, Los Angeles, CA, USA

Correspondence

Fred Poordad, MD, Chief, Hepatology and Liver Transplantation, Cedars-Sinai

Medical Center, 8635 W. 3rd Street #1060-W, Los Angeles, CA 90048, USA

Tel: +1 310 423 6000

Fax: +1 310 423 0234

e-mail: fred.poordad@...

Wiley & Sons A/S

KEYWORDS

alcoholism • comorbidities • diabetes mellitus • hepatitis C • kidney failure •

substance abuse

ABSTRACT

Background: Hepatitis C virus (HCV) infection is implicated in an increasing

number of liver transplantations, hospitalizations and healthcare costs.

Aims: We present an updated assessment of comorbidities associated with HCV in

comparison to the general US population.

Methods: Cross-sectional retrospective review of data from 800 patients with HCV

evaluated between January 1998 and November 2007. Patient data were

prospectively collected using a standardized questionnaire completed at the

first encounter and was compared with general US epidemiological data. Odds

ratios and 95% confidence intervals (CI) are reported.

Results: HCV conferred a 44% (CI 1.16–1.78) and 25% (CI 1.01–1.54) increased

risk of diabetes (12.5 vs. 7.3–8.4%; P=0.001) and obesity (23.9 vs. 19.8–33.1%;

P=0.041), respectively, compared with the US population. Human immunodeficiency

virus (HIV) (5.3 vs. 0.3%; P<0.001) and end-stage renal disease (ESRD) (4.5 vs.

0.2%; P<0.001) were 16- and 13-fold more prevalent in HCV. Interestingly, HCV

bestowed 90% decreased odds (CI 0.09–0.15) for hyperlipidaemia (12.3 vs.

53.2–56.1%; P<0.001). The HCV population had a higher prevalence of significant

alcohol consumption (41.5 vs. 4.7%; P<0.001), current smoking (57.7 vs.

18.8–20.8%; P<0.001), drug use (46.8 vs. 14.6–15.6%; P<0.001), incarceration

(6.6 vs. 2.7%; P<0.001) and tattoos (20.3 vs. 14%; P=0.011), as well as chronic

fatigue (44.6 vs. 11.3–19%; P<0.001) and depression (29.3 vs. 5.0–10.3%;

P<0.001).

Conclusion: HCV poses an increasing healthcare burden associated with increased

prevalence of diabetes, obesity, HIV, ESRD, maladaptive lifestyle habits and

poor quality of life. Practitioners should be cognizant of these trends in order

to appropriately manage these comorbidities.

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Received 2 January 2010

Accepted 17 February 2010

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1478-3231.2010.02235

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