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Alcohol use disorders and the risk of progression of liver disease in people with hepatitis C virus infection – a systematic review

Liver cirrhosis and other chronic liver diseases are usually compartmentalized into separate categories based on etiology (e.g., due to alcohol, virus infection, etc.), but it is important to study the intersection of, and possible interactions between, risk factors. The aim of this study is to summ...

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Autores principales: Llamosas-Falcón, Laura, Shield, Kevin D., Gelovany, Maya, Manthey, Jakob, Rehm, Jürgen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325038/
https://www.ncbi.nlm.nih.gov/pubmed/32605584
http://dx.doi.org/10.1186/s13011-020-00287-1
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author Llamosas-Falcón, Laura
Shield, Kevin D.
Gelovany, Maya
Manthey, Jakob
Rehm, Jürgen
author_facet Llamosas-Falcón, Laura
Shield, Kevin D.
Gelovany, Maya
Manthey, Jakob
Rehm, Jürgen
author_sort Llamosas-Falcón, Laura
collection PubMed
description Liver cirrhosis and other chronic liver diseases are usually compartmentalized into separate categories based on etiology (e.g., due to alcohol, virus infection, etc.), but it is important to study the intersection of, and possible interactions between, risk factors. The aim of this study is to summarize evidence on the association between alcohol use disorders (AUDs) and decompensated liver cirrhosis and other complications in patients with chronic Hepatitis C virus (HCV) infection. A systematic search of epidemiological studies was conducted using Ovid Medline databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Relative Risk estimates were combined using random-effects meta-analyses. The proportion of cases with liver disease progression that could be avoided if no person with a chronic HCV infection had an AUD was estimated using an attributable fraction methodology. A total of 11 studies fulfilled the inclusion criteria, providing data from 286,641 people with chronic HCV infections, of whom 63,931 (22.3%) qualified as having an AUD. Using decompensated liver cirrhosis as the outcome for the main meta-analysis (n = 7 unique studies), an AUD diagnosis was associated with a 3.3-fold risk for progression of liver disease among people with a chronic HCV infection (95% Confidence Interval (CI): 1.8–4.8). In terms of population-attributable fractions, slightly less than 4 out of 10 decompensated liver cirrhosis cases were attributable to an AUD: 35.2% (95% CI: 16.2–47.1%). For a secondary analyses, all outcomes related to liver disease progression were pooled (i.e., liver deaths or cirrhosis in addition to decompensated liver cirrhosis), which yielded a similar overall effect (n = 13 estimates; OR = 3.7; 95% CI: 2.2–5.3) and a similar attributable fraction (39.3%; 95% CI: 21.9–50.4%). In conclusion, AUDs were frequent in people with chronic HCV infections and contributed to worsening the course of liver disease. Alcohol use and AUDs should be assessed in patients who have liver disease of any etiology, and interventions should be implemented to achieve abstinence or to reduce consumption to the greatest possible extent.
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spelling pubmed-73250382020-06-30 Alcohol use disorders and the risk of progression of liver disease in people with hepatitis C virus infection – a systematic review Llamosas-Falcón, Laura Shield, Kevin D. Gelovany, Maya Manthey, Jakob Rehm, Jürgen Subst Abuse Treat Prev Policy Review Liver cirrhosis and other chronic liver diseases are usually compartmentalized into separate categories based on etiology (e.g., due to alcohol, virus infection, etc.), but it is important to study the intersection of, and possible interactions between, risk factors. The aim of this study is to summarize evidence on the association between alcohol use disorders (AUDs) and decompensated liver cirrhosis and other complications in patients with chronic Hepatitis C virus (HCV) infection. A systematic search of epidemiological studies was conducted using Ovid Medline databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Relative Risk estimates were combined using random-effects meta-analyses. The proportion of cases with liver disease progression that could be avoided if no person with a chronic HCV infection had an AUD was estimated using an attributable fraction methodology. A total of 11 studies fulfilled the inclusion criteria, providing data from 286,641 people with chronic HCV infections, of whom 63,931 (22.3%) qualified as having an AUD. Using decompensated liver cirrhosis as the outcome for the main meta-analysis (n = 7 unique studies), an AUD diagnosis was associated with a 3.3-fold risk for progression of liver disease among people with a chronic HCV infection (95% Confidence Interval (CI): 1.8–4.8). In terms of population-attributable fractions, slightly less than 4 out of 10 decompensated liver cirrhosis cases were attributable to an AUD: 35.2% (95% CI: 16.2–47.1%). For a secondary analyses, all outcomes related to liver disease progression were pooled (i.e., liver deaths or cirrhosis in addition to decompensated liver cirrhosis), which yielded a similar overall effect (n = 13 estimates; OR = 3.7; 95% CI: 2.2–5.3) and a similar attributable fraction (39.3%; 95% CI: 21.9–50.4%). In conclusion, AUDs were frequent in people with chronic HCV infections and contributed to worsening the course of liver disease. Alcohol use and AUDs should be assessed in patients who have liver disease of any etiology, and interventions should be implemented to achieve abstinence or to reduce consumption to the greatest possible extent. BioMed Central 2020-06-30 /pmc/articles/PMC7325038/ /pubmed/32605584 http://dx.doi.org/10.1186/s13011-020-00287-1 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Llamosas-Falcón, Laura
Shield, Kevin D.
Gelovany, Maya
Manthey, Jakob
Rehm, Jürgen
Alcohol use disorders and the risk of progression of liver disease in people with hepatitis C virus infection – a systematic review
title Alcohol use disorders and the risk of progression of liver disease in people with hepatitis C virus infection – a systematic review
title_full Alcohol use disorders and the risk of progression of liver disease in people with hepatitis C virus infection – a systematic review
title_fullStr Alcohol use disorders and the risk of progression of liver disease in people with hepatitis C virus infection – a systematic review
title_full_unstemmed Alcohol use disorders and the risk of progression of liver disease in people with hepatitis C virus infection – a systematic review
title_short Alcohol use disorders and the risk of progression of liver disease in people with hepatitis C virus infection – a systematic review
title_sort alcohol use disorders and the risk of progression of liver disease in people with hepatitis c virus infection – a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325038/
https://www.ncbi.nlm.nih.gov/pubmed/32605584
http://dx.doi.org/10.1186/s13011-020-00287-1
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