335 research outputs found
Sex difference in the interaction of alcohol intake, hepatitis B virus, and hepatitis C virus on the risk of cirrhosis
Background
The joint effect of the interaction of alcohol intake, hepatitis B virus (HBV) and hepatitis C
virus (HCV) on the risk of cirrhosis is still unexplored because a large sample size is required
for this investigation.
Objective
Evaluation of interaction of HBV, HCV and alcohol abuse on the risk of cirrhosis.
Design
We analysed 12,262 consecutive patients with chronic liver disease of various aetiologies referring to 95 Italian liver units in 2001 or 2014. To evaluate the interaction between alcohol abuse,
HBV infection, and HCV infection, patients unexposed to either factors were used as reference
category. Adjustment for BMI and age was done by multiple logistic regression analysis.
Results
Females were older than males (p<0.01) and less frequently showed HBV and alcoholic
aetiology (p<0.01). In both sexes, an overtime increasing age and an increasing proportion
of subjects with liver cirrhosis was observed, reflecting a better survival (0.01).An additive interaction is observed in females: the O.R. generated by the simultaneous
presence of HBV, HCV, and alcohol (5.09; 95% C.I. 1.06–24.56) exceeds the sum (4.14) of
the O.R. generated by a single exposure (O.R. = 0.72 for HBsAg positivity, OR = 1.34 for antiHCV positivity, and O.R. = 2.08 for alcohol intake). No interaction is observed in male sex.
Conclusions
The observed gender difference suggests that the simultaneous presence of HBV/HCV
coinfection and risky alcohol intake enhances the mechanism of liver damage to a greater
extent in females than in males
non invasive methods for the assessment of hepatic fibrosis transient elastography hyaluronic acid 13c aminopyrine breath test and cytokeratin 18 fragment
Background. In the management of chronic hepatitis C (CHC) patients, liver biopsy is the gold standard for liver fibrosis assessment despite some technical limits and risks. Non-invasive approaches have been proposed as alternative methods to evaluate structural liver damage. Aim. To investigate the diagnostic accuracy of transient elastography, 13C-aminopyrine breath test ( 13 C-ABT), serum hyaluronic acid (HA) and cytokeratin 18 Asp396 fragment (CK-18) as non-invasive methods of liver fibrosis assessment ad their correlation to METAVIR score. Material and methods. In a cohort of 57 CHC patients, liver stiffness, cumulative percentage of administered dose of 13C-aminopyrine at 120 min, serum HA and serum CK-18 concentration were determined. Diagnostic accuracy in detecting significant fibrosis (F ≥ 2), severe fibrosis (F ≥ 3) and cirrhosis (F = 4) was assessed by the area under the receiver operating characteristic curve. Results. Liver fibrosis score showed a strong correlation with liver stiffness (r = 0.667; p < 0.0001) and a significant inverse correlation with 13C-ABT results (r = -0.418; p = 0.0012). A weaker correlation was found with CK18 (r = 0.329; p = 0.0126) and no correlation with HA. Areas under the curve of elastography, 13C-ABT, HA and CK18 were: 0.98, 0.75, 0.69, 0.64, respectively, for F ≥ 2; 0.97, 0.69, 0.80, 0.66, respectively, for F ≥ 3; 0.95, 0.64, 0.70, 0.56, respectively, for F = 4. Conclusion. Elastography has the best diagnostic accuracy for the assessment of the degree of liver fibrosis in CHC patients. Its application can provide an alternative useful tool for monitoring the disease evolution
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