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High risk of non-alcoholic liver disease mortality in patients with chronic hepatitis C with illicit substance use disorder

Kåberg, Martin ; Larsson, Simon B. ; Jerkeman, Anna LU ; Nystedt, Anders ; Duberg, Ann Sofi ; Kövamees, Jan ; Ydreborg, Magdalena ; Aleman, Soo ; Büsch, Katharina and Alanko Blomé, Marianne LU , et al. (2020) In Scandinavian Journal of Gastroenterology 55(5). p.574-580
Abstract

Aims: Hepatitis C virus (HCV) is a slowly progressive disease, often transmitted among people who inject drugs (PWID). Mortality in PWID is high, with an overrepresentation of drug-related causes. This study investigated the risk of death in patients with chronic hepatitis C virus (HCV) infection with or without illicit substance use disorder (ISUD). Methods: Patients with HCV were identified using the Swedish National Patient Registry according to the International Classification of Diseases-10 (ICD-10) code B18.2, with ≤5 matched comparators from the general population. Patients with ≥2 physician visits with ICD-10 codes F11, F12, F14, F15, F16, or F19 were considered to have ISUD. The underlying cause of death was analyzed for... (More)

Aims: Hepatitis C virus (HCV) is a slowly progressive disease, often transmitted among people who inject drugs (PWID). Mortality in PWID is high, with an overrepresentation of drug-related causes. This study investigated the risk of death in patients with chronic hepatitis C virus (HCV) infection with or without illicit substance use disorder (ISUD). Methods: Patients with HCV were identified using the Swedish National Patient Registry according to the International Classification of Diseases-10 (ICD-10) code B18.2, with ≤5 matched comparators from the general population. Patients with ≥2 physician visits with ICD-10 codes F11, F12, F14, F15, F16, or F19 were considered to have ISUD. The underlying cause of death was analyzed for alcoholic liver disease, non-alcoholic liver disease, liver cancer, drug-related and external causes, non-liver cancers, or other causes. Mortality risks were assessed using the standardized mortality ratio (SMR) with 95% CIs and Cox regression analyses for cause-specific hazard ratios. Results: In total, 38,186 patients with HCV were included, with 31% meeting the ISUD definition. Non-alcoholic liver disease SMRs in patients with and without ISUD were 123.2 (95% CI, 103.7–145.2) and 69.4 (95% CI, 63.8–75.3), respectively. The significant independent factors associated with non-alcoholic liver disease mortality were older age, being unmarried, male sex, and having ISUD. Conclusions: The relative risks for non-alcoholic liver disease mortality were elevated for patients with ISUD. Having ISUD was a significant independent factor for non-alcoholic liver disease. Thus, patients with HCV with ISUD should be given HCV treatment to reduce the risk for liver disease.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
chronic, Hepatitis C, liver disease, mortality, substance abuse
in
Scandinavian Journal of Gastroenterology
volume
55
issue
5
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85084499175
  • pmid:32356496
ISSN
0036-5521
DOI
10.1080/00365521.2020.1754456
language
English
LU publication?
yes
id
818b3988-02d7-40d9-bb9c-3247908f3577
date added to LUP
2020-06-15 11:26:50
date last changed
2024-04-03 09:24:24
@article{818b3988-02d7-40d9-bb9c-3247908f3577,
  abstract     = {{<p>Aims: Hepatitis C virus (HCV) is a slowly progressive disease, often transmitted among people who inject drugs (PWID). Mortality in PWID is high, with an overrepresentation of drug-related causes. This study investigated the risk of death in patients with chronic hepatitis C virus (HCV) infection with or without illicit substance use disorder (ISUD). Methods: Patients with HCV were identified using the Swedish National Patient Registry according to the International Classification of Diseases-10 (ICD-10) code B18.2, with ≤5 matched comparators from the general population. Patients with ≥2 physician visits with ICD-10 codes F11, F12, F14, F15, F16, or F19 were considered to have ISUD. The underlying cause of death was analyzed for alcoholic liver disease, non-alcoholic liver disease, liver cancer, drug-related and external causes, non-liver cancers, or other causes. Mortality risks were assessed using the standardized mortality ratio (SMR) with 95% CIs and Cox regression analyses for cause-specific hazard ratios. Results: In total, 38,186 patients with HCV were included, with 31% meeting the ISUD definition. Non-alcoholic liver disease SMRs in patients with and without ISUD were 123.2 (95% CI, 103.7–145.2) and 69.4 (95% CI, 63.8–75.3), respectively. The significant independent factors associated with non-alcoholic liver disease mortality were older age, being unmarried, male sex, and having ISUD. Conclusions: The relative risks for non-alcoholic liver disease mortality were elevated for patients with ISUD. Having ISUD was a significant independent factor for non-alcoholic liver disease. Thus, patients with HCV with ISUD should be given HCV treatment to reduce the risk for liver disease.</p>}},
  author       = {{Kåberg, Martin and Larsson, Simon B. and Jerkeman, Anna and Nystedt, Anders and Duberg, Ann Sofi and Kövamees, Jan and Ydreborg, Magdalena and Aleman, Soo and Büsch, Katharina and Alanko Blomé, Marianne and Weiland, Ola and Söderholm, Jonas}},
  issn         = {{0036-5521}},
  keywords     = {{chronic; Hepatitis C; liver disease; mortality; substance abuse}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{5}},
  pages        = {{574--580}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Gastroenterology}},
  title        = {{High risk of non-alcoholic liver disease mortality in patients with chronic hepatitis C with illicit substance use disorder}},
  url          = {{http://dx.doi.org/10.1080/00365521.2020.1754456}},
  doi          = {{10.1080/00365521.2020.1754456}},
  volume       = {{55}},
  year         = {{2020}},
}