Overweight, but not alcohol is associated with increased risk for advanced liver disease in patients with chronic hepatitis C infection- results from the German Hepatitis C-Registry (DHC-R)

Background: Obesity and alcohol are important risk factors for liver cirrhosis, but their impact in patients after chronic HCV infection (cHCV) remains unknown. Data are lacking weather the co-existence of both risk factors has a supra-additive effect on disease progression. We aimed to analyze the impact of obesity and alcohol in cHCV patients.

Methods: Patients from the German Hepatitis C-Registry were classified into six groups by overweight (BMI≥25/<25) and alcohol consumption (none, moderate<30g/40g, severe>30g/40g per week for female/male). Primary endpoint was progression to liver cirrhosis. Secondary endpoint was mortality in combination with disease progression.

Results: In total, n=5967 were included after antiviral treatment. Patient with BMI≥25/no alcohol (O/nA) had an increased risk for disease progression compared to BMI<25/moderate alcohol (L/mA). In a multivariate analysis, obesity and diabetes were independent risk factors for disease progression (OR for BMI>35 3.021 (1.811-5.039), OR for diabetes 1.532 (1.036-2.267)). O/nA and O/mA patients also had an increased risk for overall mortality and disease progression compared to L/mA. Multivariate analysis of the secondary endpoint identified again diabetes and obesity as the only independent cardiometabolic risk factors for disease progression and mortality. Interestingly, neither alcohol consumption alone nor in combination with obesity influences disease progression.

Conclusion: In conclusion, obesity increased the risk for disease progression after cHCV infection, while neither alcohol alone nor in addition to obesity impacts disease progression. Therefore, weight management in patients after cHCV is important to prevent disease progression.

Publication History

Article published online:
20 January 2025