Hepatitis C virus infection in alcoholic hepatitis: prevalence patterns and impact on in-hospital mortality

Background Hepatitis C virus (HCV) infection and alcohol abuse are common causes of cirrhosis in the USA. There are limited data on HCV prevalence and mortality trends in patients with alcoholic hepatitis (AH). Aim The present study was carried out to assess HCV prevalence and mortality in AH patients. Methods Patients with a primary or a secondary discharge diagnosis of AH obtained from the Nationwide Inpatient Sample dataset (1998-2007) were stratified based on the presence of HCV. Factors associated with HCV positivity and in-hospital mortality were examined using multivariable logistic regression. Results Of 76 957719 admissions, 111726 had AH ( 7240 were HCV positive). The prevalence of HCV in AH patients was 3.6% in 1998 and 7.7% in 2007. In-hospital mortality was 3.2% (6.3% in 1998 and 2.7% in 2007), with an similar to 7% annual decrease between 1998 and 2007. HCV was an independent predictor of in-hospital mortality after controlling for calendar year [odds ratio 1.29; 95% CI (1.12-1.49); P = 0.0005]. Conclusion Patients with AH have a higher prevalence of HCV compared with the general population. Although in-hospital mortality in AH patients has improved, HCV infection predicts a higher mortality. Further studies are required to determine the mechanisms of interaction of HCV and AH and develop treatment strategies to improve outcome of HCV-infected AH patients. Eur J Gastroenterol Hepatol 24: 1178-1184 (c) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.