Do serum markers of liver fibrosis vary by HCV infection in patients with alcohol use disorder?

Arantza Sanvisens, Alvaro Muñoz, Ferran Bolao, Paola Zuluaga, Magí Farré, Inmaculada Jarrin, Jordi Tor, Roberto Muga

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6 Citations (Scopus)


© 2018 Elsevier B.V. Introduction: HCV infection is frequent in patients with alcohol use disorder (AUD). Ethanol and hepatitis C have a synergistic effect that increases the risk of end-stage liver disease. We aimed to assess fibrosis of the liver in patients admitted to treatment of AUD. Methods: Data were collected in two hospital units between 2000 and 2014. Liver fibrosis was assessed by serum biomarkers APRI, FIB-4 and Forns, and Advanced Liver Fibrosis (ALF) was defined if APRI > 1.5, FIB-4 > 3.25 or Forns > 6.9. Correlations were analyzed by Pearson's coefficients and logistic regression models were used. Results: 1313 patients (80% M) had complete data; age at admission was 45 years (IQR: 39–52 yrs), age of initial regular alcohol consumption was 20 years (IQR: 17–26 yrs) and the amount of alcohol consumed preceding admission was 200 g/day (IQR: 120–270 g/day). Prevalence of HCV infection was 18%. Prevalence of ALF in HCV positive patients was 40.6% by APRI, 30.6% by FIB-4, and 43.3% by Forns. Correlations were high for APRI vs. FIB-4 r = 0.906, APRI vs. Forns r = 0.710, and, FIB-4 vs. Forns r = 0.825. There was no significant difference in the APRI/FIB-4 correlation by HCV status (z = 1.35, p = 0.177). However, the APRI/Forns correlation was significantly higher in HCV positive patients (p < 0.001). Patients with HCV infection were two times more likely to present with ALF at admission (OR = 2.1, 95%CI:1.5–3.1). Conclusions: HCV infection is associated with severity of fibrosis in patients with excessive alcohol consumption. In this context, APRI and FIB-4 are highly correlated which facilitates the assessment of liver damage.
Original languageEnglish
Pages (from-to)180-186
JournalDrug and Alcohol Dependence
Publication statusPublished - 1 Jul 2018


  • Alcohol use disorder
  • Hepatitis C virus
  • Liver fibrosis
  • Markers of fibrosis


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