Alcohol intake increases the risk of HCC in hepatitis C virus-related compensated cirrhosis: A prospective study

Vandenbulcke, Hélène; Moreno, Christophe; Colle, Isabelle; Knebel, Jean-François; Francque, Sven; Sersté, Thomas; George, Christophe; Galocsy, Chantal de; Laleman, Wim; Delwaide, Jean; Orlent, Hans; Lasser, Luc; Trépo, Eric; Vlierberghe, Hans Van; Michielsen, P.; Gossum, M. Van; Vos, M. De; Marot, Astrid; Doerig, Christopher; Henrion, Jean; Deltenre, Pierre

doi:10.1016/j.jhep.2016.04.031

Cited by 71 publications

(62 citation statements)

References 42 publications

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“…Contrastingly, a steep increase of anti-HCV antibody positivity was observed with age, from 10.3% in HCC cases <35 years to 66.7% in patients 65 years (p trend < 10 24 ). The median age at diagnosis of patients with HCC was 42 years [IQR [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] if positive for HBs antigen and 60 years [IQR 51-69] if positive for anti-HCV antibody (p < 10 24 ).…”

Section: General Characteristicsmentioning

confidence: 99%

“…A total of 160 cases and 320 controls were included. Cases were predominantly men (80.0%) with a median age of 47 years (IQR [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]. Hazardous alcohol use (OR Hepatocellular carcinoma (HCC) is the second most common cause of death from cancer worldwide and a leading cause of cancer in most West African countries (second in men and third in women) with over 20,000 incident cases and 20,000 deaths each year.…”

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confidence: 99%

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Etiology of hepatocellular carcinoma in West Africa, a case–control study

Jaquet

Tchounga

Tanon

et al. 2018

Intl Journal of Cancer

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Hepatocellular carcinoma (HCC) is a leading cause of cancer in West Africa where HBV infection is endemic. However, limited information is available on other risk factors such as alcohol use, HCV and HIV infection. A case-control study was conducted in referral hospitals of Abidjan (Cote d'Ivoire), Bamako (Mali) and Lome (Togo). Cases were matched with controls on age, gender and participating site. The diagnosis of HCC relied on the combination of one or more space-occupying lesions suggestive of an HCC on a standardized abdominal ultrasound and an α-fetoprotein level ≥400 ng/ml. HIV, HBV and HCV serology were performed. Hazardous alcohol use was assessed using the AUDIT questionnaire. A conditional logistic regression model was used to measure odds ratio (OR) with their 95% confidence intervals (CI). A total of 160 cases and 320 controls were included. Cases were predominantly men (80.0%) with a median age of 47 years (IQR 38-57). Hazardous alcohol use (OR = 4.5 [CI 1.1-18.5]), HBV infection (OR = 62.5 [CI 20.5-190.7]) and HCV infection OR = 35.9 [CI 10.0-130.3]) were independently associated with HCC. Combining the effect of HBV infection and alcohol, HBV-infected hazardous drinkers had an OR = 149.8 (CI 13.5-1 667.0), HBV mono-infected had an OR = 57.4 (CI 18.8-175.3) (ref: HBV-negative). Aside the independent association of alcohol use and HBV and HCV infection with HCC, a synergic effect between alcohol use and HBV infection was identified. Timely screening and care of HBV infection and hazardous drinking might prevent a significant number of HCC in West Africa.

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Section: General Characteristicsmentioning

confidence: 99%

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confidence: 99%

Etiology of hepatocellular carcinoma in West Africa, a case–control study

Jaquet

Tchounga

Tanon

et al. 2018

Intl Journal of Cancer

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“…Heavy alcohol intake in the presence of HCV infection increases the risk of cirrhosis, liver decompensation and HCC [40,41]. Vanderbulcke et al, assessed the effects of light and moderate alcohol intake in 74 patients with cirrhosis over a period of 58 months; they reported 10.6% (95% CI: 4.6-16.6) 5-year cumulative incidence rate of HCC in alcohol abstainers vs. 23.8% [42]. In patients who achieved SVR, the five-year cumulative incidence rate of HCC was 2% (95% CI: 0-5.8) vs. 21.7% (95% CI: 14.2-29.2) in patients without SVR (p = 0.0002) and the lowest risk of HCC was reported among patients who achieved SVR and did not consume alcohol (0%) during the study period.…”

Section: Confirm Svr At 24-48 Weeks Post-svrmentioning

confidence: 99%

“…Alcohol use: Is prohibited for patients with cirrhosis [42] Cigarette smoking: Is prohibited for patients with cirrhosis [75,76] Marijuana use: Daily use if not recommended in patients with fibrosis [77,78] Coffee: Is not prohibited for liver patients [79] the hepatology practice (Fig. 2).…”

Section: Lifestyle Changesmentioning

confidence: 99%

Management of the patient with SVR

Terrault

Hassanein

2016

Journal of Hepatology

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In the current era of therapy with direct-acting antiviral (DAAs) drugs, achievement of a sustained virological response (SVR) is achievable in ⩾90% of hepatitis C-infected patients. SVR benefits are well-recognized with reductions in rates of liver complications, hepatocellular carcinoma and mortality. Additional benefits include reduced morbidity related to extrahepatic and systemic manifestations of hepatitis C such as renal, dermatologic, and metabolic complications. However, not all patients will derive all of these benefits and monitoring for progression is necessary, especially in those with more advanced fibrosis. To maximize the health benefits of SVR, counseling patients on best means to maintain good liver health and prevent reinfection are also important.

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“…Misuse of alcohol is of particular concern because it accelerates disease progression (1–3), and HCV-infected patients have been reported to have higher rates of alcohol misuse (4, 5) as well as depression (4). Currently, electronic health record (EHR) data generated in the course of routine healthcare delivery are used extensively for health services and outcomes research, and other areas of applied clinical research (6) including behavioral health studies (7–10).…”

Section: Introductionmentioning

confidence: 99%

Comparison of ICD-9 Codes for Depression and Alcohol Misuse to Survey Instruments Suggests These Codes Should Be Used with Caution

et al. 2017

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Background Research suggests depression and alcohol misuse are highly prevalent among chronic hepatitis C (CHC) patients, which is of clinical concern. Aims To compare ICD-9 codes for depression and alcohol misuse to validated survey instruments. Methods Among CHC patients, we assessed how well electronic ICD-9 codes for depression and alcohol misuse predicted these disorders using validated instruments. Results Of 4,874 patients surveyed, 56% were male and 52% had a history of injection drug use. Based on the PHQ-8, the prevalence of depression was 30% compared to 14% based on ICD-9 codes within 12 months of survey, 37% from ICD-9 codes any time before or within 12 months after survey, and 48% from ICD-9 codes any time before or within 24 months after survey. ICD-9 codes predicting PHQ-8 depression had a sensitivity ranging from 59–88% and a specificity ranging from 33–65%. Based on the AUDIT-C, the prevalence of alcohol misuse was 21% compared to 3–23% using ICD-9 codes. The sensitivity of ICD9 codes to predict AUDIT-C score ranged from 9–35% and specificity from 80–98%. Overall 39% of patients reported ever binge drinking; with a sensitivity of ICD-9s to predict binge drinking ranging from 7–33% and a specificity from 84–98%. More than half of patients had either an ICD-9 code for depression, a survey score indicating depression, or both (59%); more than one-third had the same patterns for alcohol misuse (36%). Conclusions ICD-9 codes were limited in predicting current depression and alcohol misuse, suggesting that caution should be exercised when using ICD-9 codes to assess depression or alcohol misuse among CHC patient.

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Alcohol intake increases the risk of HCC in hepatitis C virus-related compensated cirrhosis: A prospective study

Cited by 71 publications

References 42 publications

Etiology of hepatocellular carcinoma in West Africa, a case–control study

Etiology of hepatocellular carcinoma in West Africa, a case–control study

Management of the patient with SVR

Comparison of ICD-9 Codes for Depression and Alcohol Misuse to Survey Instruments Suggests These Codes Should Be Used with Caution

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