Despite a marked reduction in new cases of liver cirrhosis caused by hepatitis C virus (HCV) infection, over 500,000 new cirrhosis cases in this category were estimated globally in 2019. This contribution quantifies the relationship between alcohol use and the progression of liver disease in people with HCV infections.The causal impact of different levels of alcohol use on liver cirrhosis has previously been established. The quantification of this relationship was undertaken based on a systematic search of the literature and a meta-analysis. We limited our search to longitudinal and case-control studies with biologically verified outcomes. Different sensitivity analyses were conducted to check on key assumptions and on the generalizability of the relationship.Alcohol use has a dose-dependent relationship with incident liver cirrhosis, which is linear on the log-linear level, and thus exponential on the level of Odds Ratios or other risk indicators. Each standard drink of 12 grams pure alcohol per day increases the risk by about 11%. The results were stable regardless of the statistical model used, level of adjustment, quality of the study, or outcome (i.e., liver cirrhosis, decompensated liver cirrhosis, liver deaths).Alcohol use has a marked impact on the progression of HCV infections to liver cirrhosis and more severe liver outcomes.Alcohol consumption has a significant impact on the progression of liver disease in people with HCV infections. Each alcoholic drink per day is associated with an increase in the risk of liver cirrhosis of 11%.
Laura Llamosas-Falcón, Kevin D Shield, Maya Gelovany, Omer S M Hasan, Jakob Manthey, Maristela Monteiro, Nick Walsh, Jürgen Rehm