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Chronic disease
P2-182 The influence of hepatitis C and alcohol on liver-related morbidity and mortality in Glasgow
  1. S McDonald1,2,
  2. S Hutchinson1,2,
  3. P Mills3,
  4. S Bird2,4,
  5. S Cameron5,
  6. J Dillon6,
  7. D Goldberg1
  1. 1Health Protection Scotland, Glasgow, UK
  2. 2Department of Mathematics & Statistics, University of Strathclyde, Glasgow, UK
  3. 3Gartnavel General Hospital, Glasgow, UK
  4. 4MRC Biostatistics Unit, Institute of Public Health, Cambridge, UK
  5. 5West of Scotland Specialist Virology Centre, Gartnavel General Hospital, Glasgow, UK
  6. 6Ninewells Hospital & Medical School, Dundee, UK

Abstract

Introduction 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.

Methods 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.

Results 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.

Conclusion 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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