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Hepatitis C virus genotype 3 and the risk of severe liver disease in a large population of drug users in France
Author(s) -
Larsen Christine,
Bousquet Vanina,
DelarocqueAstagneau Elisabeth,
Pioche Corinne,
RoudotThoraval Françoise
Publication year - 2010
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.21850
Subject(s) - medicine , hepatitis c virus , liver disease , odds ratio , hepatitis c , hepatology , cirrhosis , hepatocellular carcinoma , population , genotype , chronic liver disease , gastroenterology , immunology , virus , biology , biochemistry , environmental health , gene
Although risk factors for cirrhosis in chronic hepatitis C virus (HCV) infection have been identified, the role of HCV‐genotype 3 remains controversial, and limited data are available in drug users. The aim of the study was to assess risk factors for severe liver disease (cirrhosis/hepatocellular carcinoma) in HCV‐infected drug users between 2001 and 2007 in France. Patients who reported drug use and who had been referred for HCV infection to hepatology centers from a national surveillance system were identified. The severity of liver disease was assessed clinically and histologically (Metavir score). Factors associated with severe liver disease were analyzed after estimating missing values by multiple imputation (MI). Of the 4,065 drug users naive to anti‐HCV treatment who were referred to the 26 participating centers, 8.0% had severe liver disease, 25.7% were infected with HCV‐genotype 3. Factors associated independently with an increased risk of severe liver disease were HCV‐genotype 3 (adjusted odds ratio, multiple imputation (aOR MI ) = 1.6, [95% confidence interval, 95% CI: 1.2–2.1]), HIV infection (aOR MI = 1.8, [1.2–2.8]), male sex (aOR MI = 2.0, [1.4–2.8]), age over 40 years (aOR MI = 2.1, [1.6–2.9]), history of excessive alcohol consumption (aOR MI = 2.8, [2.1–3.7]), and duration of infection ≥18 years (aOR MI = 2.9, [2.0–4.3]). This analysis shows that HCV‐genotype 3 is associated with severe liver disease in drug users, independently of age, sex, duration of infection, alcohol consumption, and co‐infection with HIV. These results are in favor of earlier treatment for drug users infected with HCV‐ genotype 3 and confirm the need for concomitant care for excessive alcohol consumption. J. Med. Virol. 82:1647–1654, 2010. 2010 Wiley‐Liss, Inc.