title: Interaction of alcohol intake and cofactors on the risk of cirrhosis.
abstract: OBJECTIVE
  Evaluation of the interaction between alcohol intake and cofactors [hepatitis B virus (HBV), hepatitis C virus (HCV), body mass index] and coffee consumption on the risk of cirrhosis.
  
  
  METHODS
  Seven hundred and forty-nine consecutive patients with chronic liver disease referring to units for liver or alcohol diseases in Italy during a 6-months period. Teetotalers were excluded. The odds ratios (OR) for cirrhosis were evaluated using chronic hepatitis cases as the control group.
  
  
  RESULTS
  An alcohol intake of more than 3 units/day resulted associated with the likelihood of cirrhosis both in males (OR 4.3; 95% CI=2.5-7.3) and in females (OR 5.7; 95% CI=2.3-14.5). A multiplicative interaction on the risk of cirrhosis between risky alcohol intake and HBsAg or HCV-Ab/HCV-RNA positivity was observed. A reduction of cirrhosis risk was observed in subjects consuming more than 3 alcohol units/day with increasing coffee intake. The OR for the association with cirrhosis decreased from 2.3 (95% CI=1.2-4.4) in subjects drinking 0-2 cups of coffee/day to 1.4 (95% CI=0.6-3.6) in those drinking more than 2 cups/day.
  
  
  CONCLUSIONS
  In subjects with an alcohol intake >3 units/day the coexistence of HBV or HCV multiplies the risk of cirrhosis. Coffee represents a modulator of alcoholic cirrhosis risk.
authors.affiliation: Department of Infectious and Tropical Diseases, Policlinico Umberto I, Rome, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Stroffolini
authors.forename: Gaetano
authors.initials: G
authors.lastname: Cotticelli
authors.forename: Emanuela
authors.initials: E
authors.lastname: Medda
authors.forename: Marco
authors.initials: M
authors.lastname: Niosi
authors.forename: Camillo
authors.initials: C
authors.lastname: Del Vecchio-Blanco
authors.forename: Giovanni
authors.initials: G
authors.lastname: Addolorato
authors.forename: Enzo
authors.initials: E
authors.lastname: Petrelli
authors.forename: Maria T
authors.initials: MT
authors.lastname: Salerno
authors.forename: Antonio
authors.initials: A
authors.lastname: Picardi
authors.forename: Mauro
authors.initials: M
authors.lastname: Bernardi
authors.forename: Piero
authors.initials: P
authors.lastname: Almasio
authors.forename: Stefano
authors.initials: S
authors.lastname: Bellentani
authors.forename: Lorenzo A
authors.initials: LA
authors.lastname: Surace
authors.forename: Carmela
authors.initials: C
authors.lastname: Loguercio
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D015992:Body Mass Index; D016022:Case-Control Studies; D003069:Coffee / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000276:immunology; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D007558:Italy; D008103:Liver Cirrhosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012367:RNA, Viral / Q000097:blood; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D003069:Coffee; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral