Unhealthy Alcohol Use, HIV Infection and Risk of Liver Fibrosis in Drug Users with Hepatitis C
Muga, Roberto (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Sanvisens, Arantza (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Fuster, Daniel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Tor Aguilera, Jordi (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Martínez, Elisenda (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Pérez-Hoyos, Santiago (Hospital Universitari Vall d'Hebron)
Muñoz, Alvaro (Johns Hopkins University. Bloomberg School of Public Health)
Universitat Autònoma de Barcelona

Fecha:	2012
Resumen:	To analyze alcohol use, clinical data and laboratory parameters that may affect FIB-4, an index for measuring liver fibrosis, in HCV-monoinfected and HCV/HIV-coinfected drug users. Patients admitted for substance abuse treatment between 1994 and 2006 were studied. Socio-demographic data, alcohol and drug use characteristics and clinical variables were obtained through hospital records. Blood samples for biochemistry, liver function tests, CD4 cell count, and serology of HIV and HCV infection were collected at admission. Multivariate linear regression was used to analyze the predictors of FIB-4 increase. A total of 472 (83% M, 17% F) patients were eligible. The median age at admission was 31 years (Interquartile range (IQR) 27-35 years), and the median duration of drug use was 10 years (IQR 5. 5-15 years). Unhealthy drinking (>50 grams/day) was reported in 32% of the patients. The FIB-4 scores were significantly greater in the HCV/HIV-coinfected patients (1. 14, IQR 0. 76-1. 87) than in the HCV-monoinfected patients (0. 75, IQR 0. 56-1. 11) (p<0. 001). In the multivariate analysis, unhealthy drinking (p = 0. 034), lower total cholesterol (p = 0. 042), serum albumin (p<0. 001), higher GGT (p<0. 001) and a longer duration of addiction (p = 0. 005) were independently associated with higher FIB-4 scores in the HCV-monoinfected drug users. The effect of unhealthy drinking on FIB-4 scores disappeared in the HCV/HIV-coinfected patients, whereas lower serum albumin (p<0. 001), a lower CD4 cell count (p = 0. 006), higher total bilirubin (p<0. 001) and a longer drug addiction duration (p<0. 001) were significantly associated with higher FIB-4 values. Unhealthy alcohol use in the HCV-monoinfected patients and HIV-related immunodeficiency in the HCV/HIV-coinfected patients are important risk factors associated with liver fibrosis in the respective populations.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	PloS one, Vol. 7 (october 2012) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0046810
PMID: 23056462

7 p, 427.0 KB

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