Comorbidities associated with the increasing burden of hepatitis C infection
Comorbidities associated with the increasing burden of hepatitis C infection
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DOI：
10.1111/j.1478-3231.2010.02235.x
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发表时间：
2010-08-01
影响因子：
6.7
通讯作者：
Poordad, Fred
中科院分区：
文献类型：
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作者：
Basseri, Benjamin;Yamini, David;Poordad, Fred
背景：丙型肝炎病毒感染与越来越多的肝移植、住院和医疗费用有关。目的：与美国普通人群相比，我们提出了一项与丙型肝炎病毒相关的共病的最新评估。方法：对1998年1月至2007年11月评估的800例丙型肝炎患者的资料进行横断面回顾。患者数据是使用首次就诊时完成的标准化问卷前瞻性收集的，并与美国一般流行病学数据进行了比较。报告了优势比和95%可信区间(CI)。结果：与美国人群相比，丙型肝炎患者患糖尿病和肥胖的风险分别增加44%(CI1.16-1.78)和25%(CI1.01-1.54；P=0.001)和肥胖(23.9vs.19.8-33.1%；P=0.041)。人类免疫缺陷病毒(5.3vs.0.3%；P<；0.001)和终末期肾病(4.5vs.0.2%；P<；0.001)在丙型肝炎中的流行率分别高出16倍和13倍。有趣的是，丙型肝炎病毒使患高脂血症的几率降低90%(CI0.09-0.15)(12.3vs.53.2%-56.1%；P<；0.001)。丙型肝炎患者大量饮酒(41.5vs.4.7%；P<；0.001)、当前吸烟(57.7vs.18.8-20.8%；P<；0.001)、吸毒(46.8vs.14.6-15.6%；P<；0.001)、监禁(6.6vs.2.7%；P<；0.001)和纹身(20.3vs.14%；；此外，还有慢性疲劳(44.6vs.11.3-19%；P<；0.001)和抑郁(29.3vs.5.0-10.3%；P<；0.001)。结论：随着糖尿病、肥胖、HIV、ESRD、不适应的生活习惯和生活质量的增加，丙型肝炎造成了越来越大的医疗负担。从业者应该认识到这些趋势，以便适当地处理这些并存。
Background: Hepatitis C virus (HCV) infection is implicated in an increasing number of liver transplantations, hospitalizations and healthcare costs. Aims: We present an updated assessment of comorbidities associated with HCV in comparison to the general US population. Methods: Cross-sectional retrospective review of data from 800 patients with HCV evaluated between January 1998 and November 2007. Patient data were prospectively collected using a standardized questionnaire completed at the first encounter and was compared with general US epidemiological data. Odds ratios and 95% confidence intervals (CI) are reported. Results: HCV conferred a 44% (CI 1.16-1.78) and 25% (CI 1.01-1.54) increased risk of diabetes (12.5 vs. 7.3-8.4%; P = 0.001) and obesity (23.9 vs. 19.8-33.1%; P = 0.041), respectively, compared with the US population. Human immunodeficiency virus (HIV) (5.3 vs. 0.3%; P < 0.001) and end-stage renal disease (ESRD) (4.5 vs. 0.2%; P < 0.001) were 16- and 13-fold more prevalent in HCV. Interestingly, HCV bestowed 90% decreased odds (CI 0.09-0.15) for hyperlipidaemia (12.3 vs. 53.2-56.1%; P < 0.001). The HCV population had a higher prevalence of significant alcohol consumption (41.5 vs. 4.7%; P < 0.001), current smoking (57.7 vs. 18.8-20.8%; P < 0.001), drug use (46.8 vs. 14.6-15.6%; P < 0.001), incarceration (6.6 vs. 2.7%; P < 0.001) and tattoos (20.3 vs. 14%; P = 0.011), as well as chronic fatigue (44.6 vs. 11.3-19%; P < 0.001) and depression (29.3 vs. 5.0-10.3%; P < 0.001). Conclusion: HCV poses an increasing healthcare burden associated with increased prevalence of diabetes, obesity, HIV, ESRD, maladaptive lifestyle habits and poor quality of life. Practitioners should be cognizant of these trends in order to appropriately manage these comorbidities.