Alcohol consumption among patients with hepatitis B infection in northern Portugal considering gender and hepatitis B virus genotype differences

Abstract

Alcohol abuse is an important public health problem. In Portugal with a population of 10 millions of inhabitants, there are around 10% of alcoholics or excessive alcohol drinkers and 1% of chronically infected patients with hepatitis B virus (HBV). To examine the characteristics of patients with higher levels of alcohol consumption and to investigate the association between alcohol consumption and liver damage a total of 298 chronically infected individuals, with HBV genotyped and submitted to liver biopsy, were classified with Child's grading and separated by habits of alcohol intake, less and greater than 20 g/day. No significant differences were observed about genotype but genotypes A and D were predominant in both of them. A higher percentage of males (P ! .001) were observed in the group with alcohol intake above 20 g/day, as well a lower proportion of patients with HBeAg negativity (P #.035). In this group, biochemistry parameters, such as alanine aminotransferase (P 5 .006), aspartate aminotransferase (P 5 .001), gamma-glutamyl transferase (P ! .001) were elevated in a significantly higher proportion than in the other group. The analysis of hematological parameters showed significantly lower values of platelets (P 5 .042) and mean corpuscular volume (P ! .001) and significantly higher values of prothrombin time (P ! .001) in the group with higher levels of alcohol consumption. The characteristics of biopsy (P ! .001) and ChildePhug's classification (P 5 .002) revealed more severe results in this group. Logistic regression showed a positive association between liver damage and alcohol intake, increasing with age. In female patients, a strong positive association between alcohol intake and liver damage was also found (odds ratio: 9.379; 95% confidence interval: 0.859e468.422; P 5 .037); however, the most severe cases were only observed in women older than 45 years. In patients with HBV infection, alcohol is associated with a more severe liver disease. No evidence was found concerning association with HBV genotype. Ó

Chronic liver disease and cirrhosis among patients with hepatitis B virus infection in northern Portugal with reference to the viral genotypes

“…The analysis showed that patients classified as Child–Pugh grade B were older ( P = 0.001) and had a significantly higher percentage of alcohol intake above 20 g/day ( P = 0.004) when compared to individuals classified as Child–Pugh grade A. The same trend has been observed previously when studying the relationship between the severity of liver disease and age and alcohol consumption [Mota et al, 2010]. While this previous study reported a relationship between alcohol consumption and liver disease severity, a relaxed definition of liver disease was used, including patients with and without histological evaluation, and patients without disease reports.…”

“…The results of the study are part of a project in progress at a Portuguese university to characterize the epidemiological profile of the HBV in northern Portugal [Mota et al, 2009, 2010]. This study, within the ambit of a larger project, focuses on the epidemiological profile of liver damage, particularly cirrhosis, in patients infected chronically with HBV.…”

Effect of abstinence from alcohol on survival of patients with alcoholic cirrhosis: A systematic review and meta‐analysis

“…Hepatitis B surface antigen and/or anti‐HCV antibody were present in 13 out of 86 patients (10%) in one study, and anti‐HCV antibody was present in 72 out of 213 patients (34%) in another study . A combination of HBV/HCV infection and AC predisposed patients to a more severe disease with decreased survival . It seemed that the lack of effective controls for hepatitis viruses likely influenced the end results.…”

“…6 A combination of HBV/HCV infection and AC predisposed patients to a more severe disease with decreased survival. 26,27 It seemed that the lack of effective controls for hepatitis viruses likely influenced the end results.…”

Perfil epidemiológico e genotípico da infecção pelo vírus da hepatite B no Norte de Portugal

“…1,5 Verschuere et al 23 report that the predominant subtypes in Europe are genotypes A and D. This is true also for Portugal, especially in the Northern region of the country. 14,15 In countries where endemicity is low, and in age groups not covered by mandatory vaccination, sexual transmission is more common among males, whereas intrafamilial transmission seems to predominate among females. 14,22 Vaccination is mandatory for all newborns in Portugal since 2000.…”