Alcohol consumption among patients with hepatitis B infection in northern Portugal considering gender and hepatitis B virus genotype differences

Mota, Ana; Guedes, Fátima; Areias, Jorge; Pinho, Luciana; Cardoso, Margarida Fonseca

doi:10.1016/j.alcohol.2009.11.003

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Volume 44, Issue 2 , Pages 149-156, March 2010

Alcohol consumption among patients with hepatitis B infection in northern Portugal considering gender and hepatitis B virus genotype differences

Ana Mota
- ICBAS—Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Prof. Abel Salazar, 2, 4099-003 Porto, Portugal
- Serviço de Hematologia Clínica, Centro Hospitalar do Porto (CHP), Hospital de Santo António (HSA), Largo Abel Salazar, 4099-001 Porto, Portugal
Fátima Guedes
- Faculdade de Ciências da Saúde da Universidade Fernando Pessoa, Rua Carlos da Maia, 296, 4200-150 Porto, Portugal
Jorge Areias
- ICBAS—Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Prof. Abel Salazar, 2, 4099-003 Porto, Portugal
- Serviço de Gastrenterologia, Centro Hospitalar do Porto (CHP), Hospital de Santo António (HSA), Largo Abel Salazar, 4099-001 Porto, Portugal
Luciana Pinho
- ICBAS—Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Prof. Abel Salazar, 2, 4099-003 Porto, Portugal
- Serviço de Hematologia Clínica, Centro Hospitalar do Porto (CHP), Hospital de Santo António (HSA), Largo Abel Salazar, 4099-001 Porto, Portugal
Margarida Fonseca Cardoso
- ICBAS—Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Largo Prof. Abel Salazar, 2, 4099-003 Porto, Portugal
- CIIMAR—Centro Interdisciplinar de Investigação Marinha e Ambiental, Rua dos Bragas 177, 4050-123 Porto, Portugal
- ISPUP—Instituto de Saúde Pública da Universidade do Porto, Praça Gomes Teixeira, 4099-002 Porto, Portugal
- Corresponding author. Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Largo Prof. Abel Salazar, 2, 4099-003 Porto, Portugal. Tel.: +351-22-206-22-79.

Received 22 May 2009; received in revised form 4 November 2009; accepted 5 November 2009. published online 29 January 2010.

Abstract

Alcohol abuse is an important public health problem. In Portugal with a population of 10 millions of inhabitants, there are around 10% of alcoholics or excessive alcohol drinkers and 1% of chronically infected patients with hepatitis B virus (HBV). To examine the characteristics of patients with higher levels of alcohol consumption and to investigate the association between alcohol consumption and liver damage a total of 298 chronically infected individuals, with HBV genotyped and submitted to liver biopsy, were classified with Child's grading and separated by habits of alcohol intake, less and greater than 20g/day. No significant differences were observed about genotype but genotypes A and D were predominant in both of them. A higher percentage of males (P<.001) were observed in the group with alcohol intake above 20g/day, as well a lower proportion of patients with HBeAg negativity (P≤.035). In this group, biochemistry parameters, such as alanine aminotransferase (P=.006), aspartate aminotransferase (P=.001), gamma-glutamyl transferase (P<.001) were elevated in a significantly higher proportion than in the other group. The analysis of hematological parameters showed significantly lower values of platelets (P=.042) and mean corpuscular volume (P<.001) and significantly higher values of prothrombin time (P<.001) in the group with higher levels of alcohol consumption. The characteristics of biopsy (P<.001) and Child–Phug's classification (P=.002) revealed more severe results in this group. Logistic regression showed a positive association between liver damage and alcohol intake, increasing with age. In female patients, a strong positive association between alcohol intake and liver damage was also found (odds ratio: 9.379; 95% confidence interval: 0.859–468.422; P = .037); however, the most severe cases were only observed in women older than 45 years. In patients with HBV infection, alcohol is associated with a more severe liver disease. No evidence was found concerning association with HBV genotype.