Interaction of alcohol intake and cofactors on the risk of cirrhosis.
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.
Stroffolini
Tommaso
T
Department of Infectious and Tropical Diseases, Policlinico Umberto I, Rome, Italy.
Cotticelli
Gaetano
G
Medda
Emanuela
E
Niosi
Marco
M
Del Vecchio-Blanco
Camillo
C
Addolorato
Giovanni
G
Petrelli
Enzo
E
Salerno
Maria T
MT
Picardi
Antonio
A
Bernardi
Mauro
M
Almasio
Piero
P
Bellentani
Stefano
S
Surace
Lorenzo A
LA
Loguercio
Carmela
C
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
D003069:Coffee; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D012367:RNA, Viral