Alcohol Use Disorder Stronger Predictor of Mortality than Hepatitis C Infection

Study finds chronic hepatitis C has a limited impact on mortality unless the patient has other severe comorbidities.

Alcohol use disorder has a greater impact on mortality than hepatitis C infection short of other severe comorbidities, according to research presented at The International Liver Congress 2015.

The study noted that chronic hepatitis C virus (HCV) infection has a limited impact on mortality unless the patient also has conditions such as HIV, cancer, or chronic kidney disease. Meanwhile, people with alcohol use disorder (AUD) face a significant risk of death with higher mortality observed across all of the study subgroups.

"There is an epidemiological relationship between chronic HCV infection and AUD,” Michaël Schwarzinger, director of Translational Health Economics Network, and Vincent Mallet, professor of Hepatology at Université Paris Descartes, said in a press release.

“However, the burden of chronic HCV infection analyses barely take into account the potential confounding role of AUD on prognosis. Our primary aim was to study the confounding role of severe comorbidities and AUD on prognosis in hepatitis C patients in a real life setting."

The researchers analyzed data collected between 2008 and 2012 for nearly 29 million adults in metropolitan France who were hospitalized, of which approximately 1.5 million died at the hospital. All patients were characterized by severe comorbidities, with their trajectory tracked by chronic HCV infection and/or AUD.

Chronic HCV infection was found in 112,146 (0.39%) of the patients, while AUD was found in 705,259 (2.44%). Both chronic HCV and AUD were found in 23,351 (20.8%) of the patients. The results revealed that chronic HCV infection was mostly associated with higher mortality risks in patients with severe comorbidities, including HIV or in patients who received a liver transplant.

In patients who did not have severe comorbidities, the prognostic value of chronic HCV infection was mostly due to end-stage liver disease and mortality associated with AUD.

Furthermore, AUD was linked to higher mortality risks in all hospitalized patients, with alcohol withdrawal or abstinence significantly associated with lower mortality risks.

"These results show that alcohol use disorders are a much more accurate indicator of mortality in chronic HCV infection, and highlight the need to encourage alcohol withdrawal and abstinence in all patients," Professor Tom Hemming Karlsen of the European Association for the Study of the Liver said in a press release.