Chronic liver disease in central Harlem

The role of alcohol and viral hepatitis

Thomas R. Frieden, Lisa Ozick, Colin McCord, Omana V. Nainan, Sara Workman, Gail Comer, Tai Ping Lee, Kwan Soo Byun, Dhiren Patel, Kelly J. Henning

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

For reasons not yet determined, chronic liver disease (CLD) has been a leading cause of excess morbidity and mortality in central Harlem. We conducted a case series and case-control analysis of demographic, clinical, epidemiological, and alcohol-intake-related information from patients with CLD and age- and sex-matched hospitalized control patients. Patients' sera were tested for markers of viral hepatitis. The presumed etiology of CLD among case-patients was as follows: both alcohol abuse and hepatitis C virus (HCV) infection, 24 persons (46% of case-patients); alcohol abuse alone, 15 (29%); HCV infection alone, 6 (12%); both alcohol abuse and chronic hepatitis B virus (HBV) infection, 3 (6%); and 1 each (2%) from: 1) schistosomiasis, 2) sarcoidosis, 3) unknown causes, and 4) alcohol abuse, chronic HBV, and HCV combined. In the case-control analysis, patients who had both alcoholism and either HBV (odds ratio [OR]: 6.3; 95% CI: 0.5-334) or HCV (OR: 2.9; 95% CI: 1.3-6.2) were at increased risk for CLD, whereas patients who had only one of these three factors were not at increased risk for CLD. Patients who tested positive for the hepatitis G virus (HGV) did not have a significantly increased risk of CLD, and neither severity of CLD nor mortality was greater among these patients. Most patients in central Harlem who had CLD had liver damage from a combination of alcohol abuse and chronic viral hepatitis. Alcohol and hepatitis viruses appear to be synergistically hepatotoxic; this synergy appears to explain both the high rate of CLD in central Harlem and the recent reductions in this rate. Persons at risk for chronic HBV and HCV infection should be counseled about their increased risk of CLD if they consume excessive alcohol. Morbidity and mortality from liver disease could be decreased further by a reduction in alcohol consumption among persons who have chronic HBV and HCV infection, avoidance of needle sharing, and hepatitis B vaccination.

Original languageEnglish
Pages (from-to)883-888
Number of pages6
JournalHepatology
Volume29
Issue number3
DOIs
Publication statusPublished - 1999 Jan 1
Externally publishedYes

Fingerprint

Hepatitis
Liver Diseases
Chronic Disease
Alcohols
Hepacivirus
Alcoholism
Virus Diseases
Hepatitis B virus
Chronic Hepatitis B
Mortality
Odds Ratio
Needle Sharing
GB virus C
Morbidity
Hepatitis Viruses
Schistosomiasis
Chronic Hepatitis
Sarcoidosis
Hepatitis B
Alcohol Drinking

ASJC Scopus subject areas

  • Hepatology

Cite this

Frieden, T. R., Ozick, L., McCord, C., Nainan, O. V., Workman, S., Comer, G., ... Henning, K. J. (1999). Chronic liver disease in central Harlem: The role of alcohol and viral hepatitis. Hepatology, 29(3), 883-888. https://doi.org/10.1002/hep.510290308

Chronic liver disease in central Harlem : The role of alcohol and viral hepatitis. / Frieden, Thomas R.; Ozick, Lisa; McCord, Colin; Nainan, Omana V.; Workman, Sara; Comer, Gail; Lee, Tai Ping; Byun, Kwan Soo; Patel, Dhiren; Henning, Kelly J.

In: Hepatology, Vol. 29, No. 3, 01.01.1999, p. 883-888.

Research output: Contribution to journalArticle

Frieden, TR, Ozick, L, McCord, C, Nainan, OV, Workman, S, Comer, G, Lee, TP, Byun, KS, Patel, D & Henning, KJ 1999, 'Chronic liver disease in central Harlem: The role of alcohol and viral hepatitis', Hepatology, vol. 29, no. 3, pp. 883-888. https://doi.org/10.1002/hep.510290308
Frieden TR, Ozick L, McCord C, Nainan OV, Workman S, Comer G et al. Chronic liver disease in central Harlem: The role of alcohol and viral hepatitis. Hepatology. 1999 Jan 1;29(3):883-888. https://doi.org/10.1002/hep.510290308
Frieden, Thomas R. ; Ozick, Lisa ; McCord, Colin ; Nainan, Omana V. ; Workman, Sara ; Comer, Gail ; Lee, Tai Ping ; Byun, Kwan Soo ; Patel, Dhiren ; Henning, Kelly J. / Chronic liver disease in central Harlem : The role of alcohol and viral hepatitis. In: Hepatology. 1999 ; Vol. 29, No. 3. pp. 883-888.
@article{14bbfb366abc4b8ea9bdb7fb0a918368,
title = "Chronic liver disease in central Harlem: The role of alcohol and viral hepatitis",
abstract = "For reasons not yet determined, chronic liver disease (CLD) has been a leading cause of excess morbidity and mortality in central Harlem. We conducted a case series and case-control analysis of demographic, clinical, epidemiological, and alcohol-intake-related information from patients with CLD and age- and sex-matched hospitalized control patients. Patients' sera were tested for markers of viral hepatitis. The presumed etiology of CLD among case-patients was as follows: both alcohol abuse and hepatitis C virus (HCV) infection, 24 persons (46{\%} of case-patients); alcohol abuse alone, 15 (29{\%}); HCV infection alone, 6 (12{\%}); both alcohol abuse and chronic hepatitis B virus (HBV) infection, 3 (6{\%}); and 1 each (2{\%}) from: 1) schistosomiasis, 2) sarcoidosis, 3) unknown causes, and 4) alcohol abuse, chronic HBV, and HCV combined. In the case-control analysis, patients who had both alcoholism and either HBV (odds ratio [OR]: 6.3; 95{\%} CI: 0.5-334) or HCV (OR: 2.9; 95{\%} CI: 1.3-6.2) were at increased risk for CLD, whereas patients who had only one of these three factors were not at increased risk for CLD. Patients who tested positive for the hepatitis G virus (HGV) did not have a significantly increased risk of CLD, and neither severity of CLD nor mortality was greater among these patients. Most patients in central Harlem who had CLD had liver damage from a combination of alcohol abuse and chronic viral hepatitis. Alcohol and hepatitis viruses appear to be synergistically hepatotoxic; this synergy appears to explain both the high rate of CLD in central Harlem and the recent reductions in this rate. Persons at risk for chronic HBV and HCV infection should be counseled about their increased risk of CLD if they consume excessive alcohol. Morbidity and mortality from liver disease could be decreased further by a reduction in alcohol consumption among persons who have chronic HBV and HCV infection, avoidance of needle sharing, and hepatitis B vaccination.",
author = "Frieden, {Thomas R.} and Lisa Ozick and Colin McCord and Nainan, {Omana V.} and Sara Workman and Gail Comer and Lee, {Tai Ping} and Byun, {Kwan Soo} and Dhiren Patel and Henning, {Kelly J.}",
year = "1999",
month = "1",
day = "1",
doi = "10.1002/hep.510290308",
language = "English",
volume = "29",
pages = "883--888",
journal = "Hepatology",
issn = "0270-9139",
publisher = "John Wiley and Sons Ltd",
number = "3",

}

TY - JOUR

T1 - Chronic liver disease in central Harlem

T2 - The role of alcohol and viral hepatitis

AU - Frieden, Thomas R.

AU - Ozick, Lisa

AU - McCord, Colin

AU - Nainan, Omana V.

AU - Workman, Sara

AU - Comer, Gail

AU - Lee, Tai Ping

AU - Byun, Kwan Soo

AU - Patel, Dhiren

AU - Henning, Kelly J.

PY - 1999/1/1

Y1 - 1999/1/1

N2 - For reasons not yet determined, chronic liver disease (CLD) has been a leading cause of excess morbidity and mortality in central Harlem. We conducted a case series and case-control analysis of demographic, clinical, epidemiological, and alcohol-intake-related information from patients with CLD and age- and sex-matched hospitalized control patients. Patients' sera were tested for markers of viral hepatitis. The presumed etiology of CLD among case-patients was as follows: both alcohol abuse and hepatitis C virus (HCV) infection, 24 persons (46% of case-patients); alcohol abuse alone, 15 (29%); HCV infection alone, 6 (12%); both alcohol abuse and chronic hepatitis B virus (HBV) infection, 3 (6%); and 1 each (2%) from: 1) schistosomiasis, 2) sarcoidosis, 3) unknown causes, and 4) alcohol abuse, chronic HBV, and HCV combined. In the case-control analysis, patients who had both alcoholism and either HBV (odds ratio [OR]: 6.3; 95% CI: 0.5-334) or HCV (OR: 2.9; 95% CI: 1.3-6.2) were at increased risk for CLD, whereas patients who had only one of these three factors were not at increased risk for CLD. Patients who tested positive for the hepatitis G virus (HGV) did not have a significantly increased risk of CLD, and neither severity of CLD nor mortality was greater among these patients. Most patients in central Harlem who had CLD had liver damage from a combination of alcohol abuse and chronic viral hepatitis. Alcohol and hepatitis viruses appear to be synergistically hepatotoxic; this synergy appears to explain both the high rate of CLD in central Harlem and the recent reductions in this rate. Persons at risk for chronic HBV and HCV infection should be counseled about their increased risk of CLD if they consume excessive alcohol. Morbidity and mortality from liver disease could be decreased further by a reduction in alcohol consumption among persons who have chronic HBV and HCV infection, avoidance of needle sharing, and hepatitis B vaccination.

AB - For reasons not yet determined, chronic liver disease (CLD) has been a leading cause of excess morbidity and mortality in central Harlem. We conducted a case series and case-control analysis of demographic, clinical, epidemiological, and alcohol-intake-related information from patients with CLD and age- and sex-matched hospitalized control patients. Patients' sera were tested for markers of viral hepatitis. The presumed etiology of CLD among case-patients was as follows: both alcohol abuse and hepatitis C virus (HCV) infection, 24 persons (46% of case-patients); alcohol abuse alone, 15 (29%); HCV infection alone, 6 (12%); both alcohol abuse and chronic hepatitis B virus (HBV) infection, 3 (6%); and 1 each (2%) from: 1) schistosomiasis, 2) sarcoidosis, 3) unknown causes, and 4) alcohol abuse, chronic HBV, and HCV combined. In the case-control analysis, patients who had both alcoholism and either HBV (odds ratio [OR]: 6.3; 95% CI: 0.5-334) or HCV (OR: 2.9; 95% CI: 1.3-6.2) were at increased risk for CLD, whereas patients who had only one of these three factors were not at increased risk for CLD. Patients who tested positive for the hepatitis G virus (HGV) did not have a significantly increased risk of CLD, and neither severity of CLD nor mortality was greater among these patients. Most patients in central Harlem who had CLD had liver damage from a combination of alcohol abuse and chronic viral hepatitis. Alcohol and hepatitis viruses appear to be synergistically hepatotoxic; this synergy appears to explain both the high rate of CLD in central Harlem and the recent reductions in this rate. Persons at risk for chronic HBV and HCV infection should be counseled about their increased risk of CLD if they consume excessive alcohol. Morbidity and mortality from liver disease could be decreased further by a reduction in alcohol consumption among persons who have chronic HBV and HCV infection, avoidance of needle sharing, and hepatitis B vaccination.

UR - http://www.scopus.com/inward/record.url?scp=0032978311&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032978311&partnerID=8YFLogxK

U2 - 10.1002/hep.510290308

DO - 10.1002/hep.510290308

M3 - Article

VL - 29

SP - 883

EP - 888

JO - Hepatology

JF - Hepatology

SN - 0270-9139

IS - 3

ER -