Hepatology Section, Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Liver Int. 2010 Aug;30(7):1012-8. doi: 10.1111/j.1478-3231.2010.02235.x. Epub 2010 Apr 8.
Hepatitis C virus (HCV) infection is implicated in an increasing number of liver transplantations, hospitalizations and healthcare costs.
We present an updated assessment of comorbidities associated with HCV in comparison to the general US population.
Cross-sectional retrospective review of data from 800 patients with HCV evaluated between January 1998 and November 2007. Patient data were prospectively collected using a standardized questionnaire completed at the first encounter and was compared with general US epidemiological data. Odds ratios and 95% confidence intervals (CI) are reported.
HCV conferred a 44% (CI 1.16-1.78) and 25% (CI 1.01-1.54) increased risk of diabetes (12.5 vs. 7.3-8.4%; P=0.001) and obesity (23.9 vs. 19.8-33.1%; P=0.041), respectively, compared with the US population. Human immunodeficiency virus (HIV) (5.3 vs. 0.3%; P<0.001) and end-stage renal disease (ESRD) (4.5 vs. 0.2%; P<0.001) were 16- and 13-fold more prevalent in HCV. Interestingly, HCV bestowed 90% decreased odds (CI 0.09-0.15) for hyperlipidaemia (12.3 vs. 53.2-56.1%; P<0.001). The HCV population had a higher prevalence of significant alcohol consumption (41.5 vs. 4.7%; P<0.001), current smoking (57.7 vs. 18.8-20.8%; P<0.001), drug use (46.8 vs. 14.6-15.6%; P<0.001), incarceration (6.6 vs. 2.7%; P<0.001) and tattoos (20.3 vs. 14%; P=0.011), as well as chronic fatigue (44.6 vs. 11.3-19%; P<0.001) and depression (29.3 vs. 5.0-10.3%; P<0.001).
HCV poses an increasing healthcare burden associated with increased prevalence of diabetes, obesity, HIV, ESRD, maladaptive lifestyle habits and poor quality of life. Practitioners should be cognizant of these trends in order to appropriately manage these comorbidities.
丙型肝炎病毒（HCV）感染与越来越多的肝移植、住院和医疗保健费用有关。
我们对 HCV 相关合并症进行了更新评估，并与美国一般人群进行了比较。
对 1998 年 1 月至 2007 年 11 月期间评估的 800 例 HCV 患者的数据进行横断面回顾性研究。患者数据使用标准化问卷在首次就诊时前瞻性收集，并与美国一般流行病学数据进行比较。报告比值比和 95%置信区间（CI）。
与美国人群相比，HCV 分别使糖尿病（12.5% vs. 7.3-8.4%；P=0.001）和肥胖（23.9% vs. 19.8-33.1%；P=0.041）的风险增加了 44%（CI 1.16-1.78）和 25%（CI 1.01-1.54）。人类免疫缺陷病毒（HIV）（5.3% vs. 0.3%；P<0.001）和终末期肾病（ESRD）（4.5% vs. 0.2%；P<0.001）在 HCV 中更为常见。有趣的是，HCV 使血脂异常（12.3% vs. 53.2-56.1%；P<0.001）的可能性降低了 90%（CI 0.09-0.15）。HCV 人群中大量饮酒（41.5% vs. 4.7%；P<0.001）、当前吸烟（57.7% vs. 18.8-20.8%；P<0.001）、药物使用（46.8% vs. 14.6-15.6%；P<0.001）、监禁（6.6% vs. 2.7%；P<0.001）和纹身（20.3% vs. 14%；P=0.011）更为常见，以及慢性疲劳（44.6% vs. 11.3-19%；P<0.001）和抑郁（29.3% vs. 5.0-10.3%；P<0.001）。
HCV 导致糖尿病、肥胖、HIV、ESRD、不良生活方式习惯和生活质量下降的患病率增加，从而带来越来越大的医疗保健负担。医生应意识到这些趋势，以便能够适当管理这些合并症。
