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Hepatol 1998 Jun;28(6):945-950
Retrospective analysis of the impact of HIV infection and alcohol use
on chronic hepatitis C in a large cohort of drug users.
Pol S, Lamorthe B, Thi NT, Thiers V, Carnot F, Zylberberg H, Berthelot
P, Brechot C, Nalpas B
Unite d'Hepatologie, Hopital Necker, Paris, France.
BACKGROUND/AIM:
This retrospective study aimed to better define the respective biological and
pathological impact of human immunodeficiency virus infection and chronic alcohol
consumption on the course of hepatitis C virus infection in intravenous drug
users. METHODS: Two hundred and ten consecutive anti-HCV positive intravenous
drug users, among whom 60 were also anti-HIV positive, took part in the study
at the University Hospital, Paris, France.
RESULTS:
The activity of aspartate aminotransferase and gamma-glutamyl transpeptidase
was significantly increased in serum from anti-HIV positive patients. The mean
hepatitis activity index was significantly higher in anti-HIV positive patients
(p<0.05), among whom there was also a higher proportion of patients with
cirrhosis as compared to anti-HIV negative patients (30.0 vs 15.3%, p<0.0001).
Excessive alcohol drinking (recorded in around 35% of the patients, whatever
their HIV status), as compared to non-excessive drinking, was more often associated
with cirrhosis in anti-HIV negative (24.5 vs 11.3%, p<0.05) than in anti-HIV
positive patients (30.4 vs 29.7%, not significant). In a multivariate analysis,
HIV infection (relative risk 2.2, confidence interval 1.1-4.5) and excessive
alcohol drinking (relative risk 1.9, confidence interval 1.0-3.9) were the variables
independently associated with the risk of cirrhosis.
CONCLUSION:
Human immunodeficiency virus infection worsens the course of chronic hepatitis
C in intravenous drug users. Excessive alcohol drinking also appears to be a
crucial negative cofactor, and therefore alcohol withdrawal should be proposed
as an integral part of the therapy.
PMID: 9672168, UI: 98335889
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