Background and Aims: Obesity and alcohol are important risk factors for the development of liver cirrhosis.
However, 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
consumption in cHCV patients.
Method: Patients from the German Hepatitis C-Registry were classified into four groups according
to the presence of overweight (BMI≥25 vs. BMI<25) and the presence of alcohol consumption
(none, vs. any alcohol). Primary endpoint was progression to liver cirrhosis. Secondary
endpoint was mortality in combination with disease progression.
Results: In total, n=5967 patients were included after antiviral treatment. Patients with
BMI≥25/no alcohol (O/nA) had an increased risk for progress of liver cirrhosis compared
to BMI<25/ alcohol (L/A). In a multivariate analysis, obesity and diabetes were independent
risk factors for disease progression (OR for BMI>35 2.833 (1.682-4.771), OR for diabetes
1.489 (1.004-2.208). O/nA patients also had an increased risk for overall mortality
and disease progression compared to L/A. 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 consumption alone nor in addition to obesity impacts disease
progression. Therefore, weight management in patients after cHCV is important to prevent
disease progression.
