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Impact of diabetes mellitus and hepatitis B virus coinfection on patients with chronic hepatitis C: A territory‐wide cohort study
Author(s) -
Subramaniam Shreenidhi,
Wong Vincent WaiSun,
Tse YeeKit,
Yip Terry CheukFung,
Chan Henry LikYuen,
Wong Grace LaiHung
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14003
Subject(s) - medicine , coinfection , hepatitis c virus , diabetes mellitus , hepatitis b virus , cohort , hepatitis c , cohort study , hepatitis b , risk factor , retrospective cohort study , immunology , virus , endocrinology
Abstract Background and Aim Studies have demonstrated a higher prevalence of diabetes mellitus (DM) in patients with chronic hepatitis C (CHC). Furthermore, coinfection with hepatitis B virus (HBV) is common because of its endemicity in Asian–Pacific regions. The aim of the present study was to investigate the impact of DM and HBV coinfection on the clinical outcomes in Chinese CHC patients. Methods A territory‐wide cohort study was conducted using the database from Hospital Authority, the sole public medical service provider in Hong Kong. CHC patients were identified by the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes, diagnosed between 2000 and 2012. The primary outcome was overall mortality. Results A total of 7149 CHC patients were included. Seven hundred twenty‐two (10.1%) patients were coinfected with HBV. Their mean age was 56 years; 69.0% were men. The prevalence of DM was similar in mono‐infection and coinfection cohorts (22.3% and 21.3%, respectively). Multivariable analysis identified DM as an independent risk factor for death and antiviral treatment for hepatitis C virus (HCV) as an independent protective factor against death. The 5‐year survival of CHC patients with mono‐infection was better than that of HBV coinfected patients (62.5% vs 57.0%; P = 0.001). The 5‐year survival of patients who did or did not receive antiviral treatment for HCV was 94.7% and 55.2%, respectively ( P < 0.001). Conclusions Hepatitis B virus coinfection and DM were independent risk factors for death in Hong Kong CHC patients. Antiviral treatment for HCV but not HBV was a protective factor against death.