Contribution of alcohol use disorders on the burden of chronic hepatitis C in France, 2008–2013: A nationwide retrospective cohort study | SNFGE.org - Société savante médicale française d'hépato-gastroentérologie et d’oncologie digestive
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Thématique :
- Foie
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Très original
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Intermédiaire
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Immédiatement
 
 
Nom du veilleur :
Docteur Jean-Louis PAYEN
Coup de coeur :
 
 
Journal of Hepatology
  2017/09  
 
  2017 Sep;67(3):454-461.  
  doi: 10.1016/j.jhep.2017.03.031.  
 
  Contribution of alcohol use disorders on the burden of chronic hepatitis C in France, 2008–2013: A nationwide retrospective cohort study  
 
  Schwarzinger M, Baillot S, Yazdanpanah Y, Rehm J, Mallet V  
  https://www.ncbi.nlm.nih.gov/pubmed/28396173  
 
 

Abstract

BACKGROUND & AIMS:

Hepatitis C virus (HCV) patients are at risk of alcohol use disorders (AUDs). We measured the contribution of AUDs on the burden of chronic HCV infection in French HCV patients.

METHODS:

The hospital trajectory of 97,347 French HCV patients aged 18-65 in January 2008 were tracked and followed until in-hospital death or December 2013. Primary outcome was the frequency of liver-related complications. Secondary outcomes were the frequency of liver transplantation and otherwise cause-specific mortality. Adjusted odds ratios (OR), population attributable risks of AUDs and other cofactors of liver disease progression associated with HCV transmission were measured.

RESULTS:

The 28,101 (28.9%) individuals with AUDs had the highest odds for liver-related complications (OR=7.19; 95% confidence interval [CI], 6.90 to 7.50), liver transplantation (OR=4.28; 95% CI, 3.80 to 4.82), and liver death (OR=6.20; 95% CI, 5.85 to 6.58). Alcohol rehabilitation and abstinence were associated with 60% (95% CI, 57% to 63%) and 78% (95% CI, 76% to 80%) reduction of liver-related complications, respectively. The attributable risk of AUDs was 71.8% (95% CI, 66.0 to 76.8) of 17,669 liver-related complications, 67.4% (95% CI, 61.6 to 72.4) of 1,599 liver transplantations, and 68.8% (95% CI, 63.4 to 73.5) of 6,677 liver deaths. The number of liver transplantations remained stable and the number of liver deaths increased, at a faster rate for individuals with AUDs, over the observational period.

CONCLUSION:

In France, AUDs contributed to more than two-thirds of the burden of chronic HCV infection in young and middle-aged adults over 2008-2013.

LAY SUMMARY:

This study tracked liver-related complications and mortality of all 97,347 young and middle-aged patients (18-65years old) discharged with chronic HCV infection from French hospitals over 2008-2013. About 30% patients were recorded with alcohol use disorders (AUDs) and had the highest odds for liver-related complications (i.e. decompensated cirrhosis and liver cancer). AUDs contributed to more than two-thirds of 1,599 liver transplantations and 6,677 liver deaths recorded in patients with chronic HCV infection over 2008-2013 in France. Alcohol rehabilitation and abstinence were associated with above a 50% risk reduction of liver-related complications. Promoting alcohol abstinence should receive high priority to reduce the burden of chronic HCV infection.

 

 
Question posée
 
Impact de la consommation d’alcool chez les patients porteurs d’une hépatite virale C.
 
Question posée
 
En France, les complications liées à la consommation d’alcool ont contribué à plus des deux tiers du poids de l'infection chronique par le VHC chez les jeunes et les adultes d'âge moyen sur la période 2008-2013.
 
Commentaires

On a tous conscience que le cumul des pathologies est un facteur aggravant les pathologies, cette étude en fait la magnifique démonstration.

 
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