Alcohol, tobacco and coffee consumption and liver disease severity among individuals with Chronic Hepatitis B infection in North America

Ann Hepatol. 2020 Jul-Aug;19(4):437-445. doi: 10.1016/j.aohep.2020.01.005. Epub 2020 Feb 8.

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.

Keywords: Alcohol; Chronic Hepatitis B; Coffee; Hepatitis B Research Network; Tobacco.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Adult
  • Africa / ethnology
  • Aged
  • Alanine Transaminase / blood
  • Alcohol Drinking / epidemiology*
  • Asia / ethnology
  • Asian People
  • Black People
  • Black or African American
  • Canada / epidemiology
  • Coffee*
  • DNA, Viral / blood
  • Female
  • Hepatitis B e Antigens / blood
  • Hepatitis B, Chronic / blood
  • Hepatitis B, Chronic / epidemiology*
  • Humans
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Severity of Illness Index
  • Tobacco Smoking / epidemiology*
  • United States / epidemiology
  • White People
  • Young Adult

Substances

  • Coffee
  • DNA, Viral
  • Hepatitis B e Antigens
  • Alanine Transaminase