Shreenidhi Subramaniam1, Vincent Wai-Sun Wong2,3,4, Yee-Kit Tse2,3,4, Terry Cheuk-Fung Yip5, Henry Lik-Yuen Chan2,3,4, Grace Lai-Hung Wong2,3,4. 1. Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong. 2. Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong. 3. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong. 4. State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong. 5. Department of Statistics, The Chinese University of Hong Kong, Shatin, Hong Kong.
Abstract
BACKGROUND AND AIM: Studies have demonstrated a higher prevalence of diabetes mellitus (DM) in patients with chronic hepatitis C (CHC). Furthermore, coinfection with hepatitis B virus (HBV) is common because of its endemicity in Asian-Pacific regions. The aim of the present study was to investigate the impact of DM and HBV coinfection on the clinical outcomes in Chinese CHC patients. METHODS: A territory-wide cohort study was conducted using the database from Hospital Authority, the sole public medical service provider in Hong Kong. CHC patients were identified by the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes, diagnosed between 2000 and 2012. The primary outcome was overall mortality. RESULTS: A total of 7149 CHC patients were included. Seven hundred twenty-two (10.1%) patients were coinfected with HBV. Their mean age was 56 years; 69.0% were men. The prevalence of DM was similar in mono-infection and coinfection cohorts (22.3% and 21.3%, respectively). Multivariable analysis identified DM as an independent risk factor for death and antiviral treatment for hepatitis C virus (HCV) as an independent protective factor against death. The 5-year survival of CHC patients with mono-infection was better than that of HBV coinfected patients (62.5% vs 57.0%; P = 0.001). The 5-year survival of patients who did or did not receive antiviral treatment for HCV was 94.7% and 55.2%, respectively (P < 0.001). CONCLUSIONS: Hepatitis B virus coinfection and DM were independent risk factors for death in Hong Kong CHC patients. Antiviral treatment for HCV but not HBV was a protective factor against death.
BACKGROUND AND AIM: Studies have demonstrated a higher prevalence of diabetes mellitus (DM) in patients with chronic hepatitis C (CHC). Furthermore, coinfection with hepatitis B virus (HBV) is common because of its endemicity in Asian-Pacific regions. The aim of the present study was to investigate the impact of DM and HBV coinfection on the clinical outcomes in Chinese CHCpatients. METHODS: A territory-wide cohort study was conducted using the database from Hospital Authority, the sole public medical service provider in Hong Kong. CHCpatients were identified by the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes, diagnosed between 2000 and 2012. The primary outcome was overall mortality. RESULTS: A total of 7149 CHCpatients were included. Seven hundred twenty-two (10.1%) patients were coinfected with HBV. Their mean age was 56 years; 69.0% were men. The prevalence of DM was similar in mono-infection and coinfection cohorts (22.3% and 21.3%, respectively). Multivariable analysis identified DM as an independent risk factor for death and antiviral treatment for hepatitis C virus (HCV) as an independent protective factor against death. The 5-year survival of CHCpatients with mono-infection was better than that of HBV coinfectedpatients (62.5% vs 57.0%; P = 0.001). The 5-year survival of patients who did or did not receive antiviral treatment for HCV was 94.7% and 55.2%, respectively (P < 0.001). CONCLUSIONS:Hepatitis B virus coinfection and DM were independent risk factors for death in Hong Kong CHCpatients. Antiviral treatment for HCV but not HBV was a protective factor against death.