Hepatitis C virus infection in alcoholic hepatitis:  prevalence patterns and impact on in-hospital mortality.
BACKGROUND
Hepatitis C virus (HCV) infection and alcohol abuse are common causes of cirrhosis in the USA. There are limited data on HCV prevalence and mortality trends in patients with alcoholic hepatitis (AH).


OBJECTIVE
The present study was carried out to assess HCV prevalence and mortality in AH patients.


METHODS
Patients with a primary or a secondary discharge diagnosis of AH obtained from the Nationwide Inpatient Sample dataset (1998-2007) were stratified based on the presence of HCV. Factors associated with HCV positivity and in-hospital mortality were examined using multivariable logistic regression.


RESULTS
Of 76 957 719 admissions, 111 726 had AH (7240 were HCV positive). The prevalence of HCV in AH patients was 3.6% in 1998 and 7.7% in 2007. In-hospital mortality was 3.2% (6.3% in 1998 and 2.7% in 2007), with an ~7% annual decrease between 1998 and 2007. HCV was an independent predictor of in-hospital mortality after controlling for calendar year [odds ratio 1.29; 95% CI (1.12-1.49); P=0.0005].


CONCLUSIONS
Patients with AH have a higher prevalence of HCV compared with the general population. Although in-hospital mortality in AH patients has improved, HCV infection predicts a higher mortality. Further studies are required to determine the mechanisms of interaction of HCV and AH and develop treatment strategies to improve outcome of HCV-infected AH patients.
Department of Internal Medicine, Division of Gastroenterology, Center for Aging, University of Texas Medical Branch, Galveston, Texas 55905, USA. ashwanisingal.com@gmail.com
Ashwani K
AK
Singal
Yong-Fang
YF
Kuo
Bhupinderjit S
BS
Anand
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016174:Hepacivirus; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology; D006519:Hepatitis, Alcoholic / Q000150:complications / Q000401:mortality*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D014481:United States / Q000453:epidemiology