Original articlePancreas, biliary tract, and liverInfection With Hepatitis C Virus Genotype 3 Is an Independent Risk Factor for End-Stage Liver Disease, Hepatocellular Carcinoma, and Liver-Related Death
Section snippets
Methods
The Alaska Native Tribal Health Consortium coordinates Alaska Tribal Health System health care throughout the state of Alaska. Further details of the population and health care delivery system have been described previously and in the Supplementary Tables 1 and 2.4 Electronic health records are used in these statewide Tribal facilities. Testing for anti-HCV was conducted at the laboratory at the Alaska Native Medical Center (ANMC); all positive results were reflexed automatically for HCV RNA
Results
Among 1132 persons found to have chronic HCV through 2012, 1080 (95.4%) were enrolled. Table 1 provides the demographic, risk factors, clinical, social, and laboratory characteristics of this cohort. Two thirds of participants (66%) were infected with HCV genotype 1, 90% were infected with HCV genotype 1a, and 19% and 14% were infected with HCV genotypes 2 and 3, respectively. At study entry, 22% of genotype 3 patients had an increased APRI score (≥1.5), which did not differ from 21% and 23% in
Discussion
The AK-HEPC study was a large and long population-based cohort study to examine the long-term outcome of chronic HCV infection. This population-based study of more than 1000 participants (94% of the known Alaska Native persons with chronic HCV infection in the state), followed up for 11,171 person-years, a mean of more than 10 years, was designed to examine prospectively the adverse events resulting from HCV infection. The study encompassed a large amount of clinical and laboratory data coupled
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Conflicts of interest These authors disclose the following: Brenna Simons, James Gove, Julia Plotnik, and Youssef Barbour have received research support from Gilead Sciences. The remaining authors disclose no conflicts.
Funding This work was supported by the Centers for Disease Control and Prevention (U01 PS001097). The findings and conclusions in this article are those of the authors and do not necessarily represent the official positions of the US Centers for Disease Control and Prevention.