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Brahmania M, Liu S, Wahed AS, Yim C, Hansen BE, Khalili M, Terrault NA, Lok AS, Ghany M, Wang J, Wong D, Janssen HL. Alcohol, tobacco and coffee consumption and liver disease severity among individuals with Chronic Hepatitis B infection in North America. Ann Hepatol 2020; 19:437-445. [PMID: 32139262 PMCID: PMC7757603 DOI: 10.1016/j.aohep.2020.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES The prevalence of alcohol, tobacco, and coffee use and association with liver health among North Americans with Chronic Hepatitis B (CHB) infection has not been well described. MATERIALS AND METHODS The Hepatitis B Research Network includes an observational study of untreated CHB adults enrolled at 21 sites in the United States and Canada. Alcohol use was categorized as none, moderate, and at-risk based on the definition from the National Institute on Alcohol Abuse and Alcoholism; tobacco use as never, current and former; coffee use as none, 1-2 cups/day, and ≥3 cups/day. Linear regression and linear mixed models were used to associate lifestyle behaviors with ALT and FIB-4 values. RESULTS 1330 participants met eligibility: 53% males, 71% Asian and the median age was 42 years (IQR: 34-52). Median ALT was 33U/L (IQR: 22-50), 37% had HBV DNA <103IU/mL, 71% were HBeAg negative, and 65% had a FIB-4 <1.45. At baseline, 8% of participants were at-risk alcohol drinkers, 11% were current smokers and 92% drank <3 cups of coffee/day. Current tobacco and 'at-risk' alcohol use, were significantly associated with elevated ALT levels in univariable analyses, however, these associations were not statistically significant when controlling for sociodemographic and HBV characteristics. CONCLUSIONS In this large diverse cohort of untreated CHB participants, at-risk alcohol use, current tobacco use and limited coffee consumption did not have an association with high ALT and FIB-4 values. In contrast, significant associations were found between the frequency of these lifestyle behaviors and sociodemographic factors.
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Affiliation(s)
- Mayur Brahmania
- Division of Gastroenterology, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Stephen Liu
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Abdus S. Wahed
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, United States
| | - Colina Yim
- Division of Gastroenterology, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Bettina E. Hansen
- Division of Gastroenterology, Toronto General Hospital, University Health Network, Toronto, Canada,IHPME, University of Toronto, Toronto, Canada
| | - Mandana Khalili
- Division of Gastroenterology and Hepatology, University of California-San Francisco, San Francisco, CA, United States
| | - Norah A. Terrault
- Division of Gastroenterology and Hepatology, University of California-San Francisco, San Francisco, CA, United States
| | - Anna S. Lok
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, United States
| | - Marc Ghany
- Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Junyao Wang
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States
| | - David Wong
- Division of Gastroenterology, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Harry L.A. Janssen
- Division of Gastroenterology, Toronto General Hospital, University Health Network, Toronto, Canada,Corresponding author. (H.L.A. Janssen)
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