title: Chronic hepatitis C virus infection: it is not only about the liver.
abstract: OBJECTIVE
  Although hepatitis B virus (HBV) and hepatitis C virus (HCV) are both hepatotropic and quite similar in terms of clinical manifestations and histopathology, their respective infections are distinct in terms of epidemiology and prognosis. Recognizing the differences between patients with HBV and HCV infection with respect to demographic characteristics, prevalence of comorbidities, and presence of lifestyle factors aids the proper treatment of these patients. We aimed to compare two populations with chronic viral liver disease (chronic HCV and chronic HBV), each of them with resolved hepatitis C.
  
  
  METHODS
  We included patients referred to a municipal reference clinic from March 2009 through May 2012. Patient data were collected using standardized questionnaires at the patients' first visit to clinic. Questionnaires included epidemiological information, presence of comorbidities, and lifestyle.
  
  
  RESULTS
  A total of 756 patients were included in the study, 348 (46.0%) with chronic HCV infection, 176 (23.3%) with chronic HBV infection, and 232 (30.7%) with resolved HCV infection. Multivariate analysis including patients with chronic HCV infection and chronic HBV infection indicated that age [adjusted odds ratio (AOR)=1.06; 95% confidence interval (CI): 1.03-1.08], alcohol abuse (AOR=1.58; 95% CI: 1.01-2.49), smoking (AOR=1.64; 95% CI: 1.00-2.17), and illicit drug (AOR=2.92; 95% CI: 1.69-5.02) use were associated independently with chronic HCV infection. Multivariate analyses including patients with chronic HCV infection and those patients with resolved HCV infection, presence of at least one comorbidity (AOR=1.94; 95% CI: 1.12-3.3), illicit drug use (AOR=3.24; 95% CI: 1.90-5.54), and age (AOR=1.03; 95% CI: 1.01-1.05) were independently associated with chronic HCV infection. Age (AOR=0.98; 95% CI: 0.96-0.99) and male sex (AOR=1.93; 95% CI: 1.26-2.95) were the only variables associated significantly with chronic HBV infection in the multivariate analysis between patients with chronic HBV infection and resolved HCV infection.
  
  
  CONCLUSIONS
  Our results highlight that patients with chronic HCV infection are complex and require a multidisciplinary approach during patient follow-up and clinical management.
authors.affiliation: Ambulatório Municipal de Hepatites Virais Ouro Verde, Campinas, SP, Brazil.
authors.forename: Aline G
authors.initials: AG
authors.lastname: Vigani
authors.forename: Raquel
authors.initials: R
authors.lastname: Tozzo
authors.forename: Audrey
authors.initials: A
authors.lastname: Quezada
authors.forename: Ana C
authors.initials: AC
authors.lastname: Diaz
authors.forename: Leandro
authors.initials: L
authors.lastname: Mendes
authors.forename: Inajara
authors.initials: I
authors.lastname: Lopes
authors.forename: Eliane
authors.initials: E
authors.lastname: Riberio
authors.forename: Glaciela M G
authors.initials: GM
authors.lastname: Espindola
authors.forename: Fernanda P
authors.initials: FP
authors.lastname: Lopes
authors.forename: Eliana C
authors.initials: EC
authors.lastname: Petoilho
authors.forename: Jose L S
authors.initials: JL
authors.lastname: Queiroz
authors.forename: Heloisa M
authors.initials: HM
authors.lastname: Castro
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D019694:Hepatitis B, Chronic / Q000453:epidemiology* / Q000209:etiology; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D055815:Young Adult