ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2017
Confluence of Epidemics of Hepatitis C, Diabetes, Obesity, and Chronic Kidney Disease in the United States Population.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Hepatitis C Virus Infection and Hospital-Related Outcomes: A Systematic Review.Canadian journal of gastroenterology & hepatology · 2024Pooled it
- Global Trends in Incidence Rates of Primary Adult Liver Cancers: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2020Pooled it
- Projected health benefits and cost offsets from the United States National Hepatitis C Elimination Initiative.Nature communications · 2026Article
- Long-Term Risk Trajectories of Diabetes Differ After Direct-Acting Antiviral and Interferon Therapy in Chronic Hepatitis C: A Real-World Cohort Study.Biomedicines · 2026Article
- The association between hepatitis C virus infection status and blood pressure in adults in the United States: NHANES 1999-2012.Frontiers in cellular and infection microbiology · 2024Article
- MAFLD: an optimal framework for understanding liver cancer phenotypes.Journal of gastroenterology · 2023Review
- Hepatitis C virus infection and risk of liver-related and non-liver-related deaths: a population-based cohort study in Naples, southern Italy.BMC infectious diseases · 2021Article
- Effect of Peroxisome Proliferator-Activated Receptor-γ Coactivator-1 Alpha Variants on Spontaneous Clearance and Fibrosis Progression during Hepatitis C Virus Infection in Moroccan Patients.Virologica Sinica · 2020Article
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- Viral Infections and Interferons in the Development of Obesity.Biomolecules · 2019Review
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- Article
- The association of hepatitis C infection with the onset of CKD and progression into ESRD.Seminars in dialysis · 2019Review
- Sustained virological response and metabolic risk factors are associated with mortality in patients with chronic hepatitis C.PloS one · 2019Article
- The impact of direct-acting antiviral therapy for hepatitis C on hepatocellular carcinoma risk.Current hepatology reports · 2018Article
- Review
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsObesity, kidney disease, and diabetes are common conditions that can affect outcomes of patients with chronic hepatitis C. The authors aimed to quantify the burden of these comorbid conditions among adults with chronic hepatitis C in the United States and to estimate the risk of death among people with chronic hepatitis C and comorbidities.
methodsThe authors conducted cross-sectional and prospective analyses of 13,726 participants in the third National Health and Nutrition Examination Survey (NHANES III) and 23,691 participants of NHANES 1999-2012. Serum samples were analyzed for the presence of antibodies to hepatitis C virus (anti-HCV); in samples found to be positive for anti-HCV, the authors quantified HCV RNA (viral load). Individuals with anti-HCV and detectable HCV RNA were considered to have chronic hepatitis C. Comorbidities were defined using self-reported, physical examination, and laboratory data, as available. The authors used logistic models and predictive margins to estimate the adjusted prevalence of comorbidities in patients with chronic hepatitis C. The authors used Poisson regression models to estimate adjusted mortality rates based on chronic hepatitis C status, with or without comorbidities. Cox proportional hazards regression models to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause, cardiovascular, and cancer mortality according to chronic hepatitis C status, with and without comorbidities.
resultsAmong persons with chronic hepatitis C, the demographic-adjusted prevalence estimate of diabetes was 17.9% (95% CI, 11.2%-27.5%) and of obesity was 20.9% (95% CI, 12.4%-29.5%). Overall, 69.6% of persons with chronic hepatitis C had at least 1 major cardiometabolic comorbidity (95% CI, 62.1%-76.2%). Only 38% of adults with chronic hepatitis C reported a diagnosis of liver disease. Chronic hepatitis C was associated with a substantially increased risk of death (HR, 2.45), especially in the presence of diabetes (HR, 3.24) or chronic kidney disease (HR, 4.39).
conclusionIn an analysis of NHANES data, the authors found that individuals with chronic hepatitis C have a high burden of major cardiometabolic comorbidities. Diabetes and chronic kidney disease, in particular, are associated with substantial excess mortality in persons with chronic hepatitis C.
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