title: Past excessive alcohol consumption: a major determinant of severe liver disease among newly referred hepatitis C virus infected patients in hepatology reference centers, France, 2001.
abstract: OBJECTIVE
  Our study aimed to identify factors associated with the occurrence of severe liver disease in hepatitis C virus (HCV) positive patients at first referral to hepatology reference centers in France in 2001.
  
  
  METHODS
  Patients reported through the national hospital-based hepatitis C surveillance system in 2001 were included. The definition of severe liver disease was based on clinical, biological, and morphological evaluation; cirrhosis (+/- complication) and primary liver cancer were classified as severe liver disease. Patient characteristics were compared for those with and without severe liver disease.
  
  
  RESULTS
  Of the 3404 newly referred patients in the 26 participating centers, 391 (11.5%) had severe liver disease. Male gender (adjusted odds ratios [aOR]=1.4; 95% confidence interval [CI], 1.0-1.9), age over 39 years at referral (aOR=3.8; 95% CI, 2.7-5.3), past excessive alcohol consumption (aOR=2.6; 95% CI, 1.9-3.5), and HIV seropositivity (aOR=1.9; 95% CI, 1.1-3.3) were each independently associated with an increased risk of severe liver disease. In the subgroup of patients with known age at time of HCV exposure, age over 39 years at time of exposure (aOR=1.6; 95% CI, 1.1-2.4), duration of HCV infection over 15 years (aOR=2.6; 95% CI, 1.8-3.7), known HBs antigen positivity (aOR=2.4; 95% CI, 1.1-5.2), and past excessive alcohol consumption (aOR=2.7; 95% CI, 1.8-3.9) were each associated with increased risk of severe liver disease.
  
  
  CONCLUSIONS
  Our findings underscore the important role of past excessive alcohol consumption on the development of severe liver disease for HCV patients.
authors.affiliation: French National Public Health Institute (InVS), Saint-Maurice cedex, France. e.delarocque@invs.sante.fr
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Delarocque-Astagneau
authors.forename: Françoise
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: Christine
authors.initials: C
authors.lastname: Campèse
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Desenclos
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects*; D003625:Data Collection; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000145:classification / Q000209:etiology*; D006801:Humans; D008107:Liver Diseases / Q000145:classification / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors