Hospitalisation for an alcohol-related cause among injecting drug users in Scotland

increased risk following diagnosis with hepatitis C infection

Scott A. McDonald, Sharon J. Hutchinson, Sheila M. Bird, Chris Robertson, Peter R. Mills, John F. Dillon, David J. Goldberg

    Research output: Contribution to journalArticle

    3 Citations (Scopus)

    Abstract

    Background: The rate of hepatitis C (HCV) related liver disease progression is known to be strongly associated with alcohol consumption, yet there are very few data on alcohol use in injecting drug users (IDUs), who represent 90% of Scotland's HCV-diagnosed population. To investigate the extent of alcohol use in IDUs, we used hospitalisation with an alcohol-related diagnosis as an indicator for problematic consumption levels, and compared admission rates pre- and post-HCV diagnosis.

    Methods: Data for 41,062 current/former IDUs attending drug treatment/support services in Scotland from April 1995 to March 2006 were linked to the national hospital discharge database to retrieve alcohol-related episodes, and to the national HCV Diagnosis database to determine HCV-diagnosed status. Relative risks were estimated using Cox proportional hazards regression for recurrent events.

    Results: The proportion of IDUs with >= 1 alcohol-related admission following first attendance at drug services was greater among those diagnosed with HCV by the end of follow-up (16%) compared with those who were not (6%). For the 9145 IDUs who had been diagnosed with HCV by 31 March 2006, there was a 1.5-fold increased relative risk of an alcohol-related admission >30 days post-HCV diagnosis (95% Cl: 1.2-1.7) compared with >30 days pre-HCV diagnosis, adjusted for sex, age, and deprivation.

    Conclusions: IDUs diagnosed with HCV infection have an increased risk of subsequent hospital admission for an alcohol-related cause. Because of the synergistic effect of HCV infection and excessive alcohol intake on the development of cirrhosis, it is imperative that alcohol intake is addressed in the management of chronic HCV infection in this population. (C) 2010 Elsevier B.V. All rights reserved.

    Original languageEnglish
    Pages (from-to)63-69
    Number of pages7
    JournalInternational Journal of Drug Policy
    Volume22
    Issue number1
    DOIs
    Publication statusPublished - Jan 2011

    Keywords

    • Alcohol
    • Hospital admissions
    • Injecting drug users
    • Hepatitis C virus
    • VIRUS-INFECTION
    • RECURRENT EVENTS
    • RECORD-LINKAGE
    • PROGRESSION
    • HIV
    • PREVALENCE
    • MORTALITY
    • CIRRHOSIS
    • PATTERNS
    • RATES

    Cite this

    McDonald, Scott A. ; Hutchinson, Sharon J. ; Bird, Sheila M. ; Robertson, Chris ; Mills, Peter R. ; Dillon, John F. ; Goldberg, David J. / Hospitalisation for an alcohol-related cause among injecting drug users in Scotland : increased risk following diagnosis with hepatitis C infection. In: International Journal of Drug Policy. 2011 ; Vol. 22, No. 1. pp. 63-69.
    @article{ae69d16d601047c6bd82af7156603202,
    title = "Hospitalisation for an alcohol-related cause among injecting drug users in Scotland: increased risk following diagnosis with hepatitis C infection",
    abstract = "Background: The rate of hepatitis C (HCV) related liver disease progression is known to be strongly associated with alcohol consumption, yet there are very few data on alcohol use in injecting drug users (IDUs), who represent 90{\%} of Scotland's HCV-diagnosed population. To investigate the extent of alcohol use in IDUs, we used hospitalisation with an alcohol-related diagnosis as an indicator for problematic consumption levels, and compared admission rates pre- and post-HCV diagnosis.Methods: Data for 41,062 current/former IDUs attending drug treatment/support services in Scotland from April 1995 to March 2006 were linked to the national hospital discharge database to retrieve alcohol-related episodes, and to the national HCV Diagnosis database to determine HCV-diagnosed status. Relative risks were estimated using Cox proportional hazards regression for recurrent events.Results: The proportion of IDUs with >= 1 alcohol-related admission following first attendance at drug services was greater among those diagnosed with HCV by the end of follow-up (16{\%}) compared with those who were not (6{\%}). For the 9145 IDUs who had been diagnosed with HCV by 31 March 2006, there was a 1.5-fold increased relative risk of an alcohol-related admission >30 days post-HCV diagnosis (95{\%} Cl: 1.2-1.7) compared with >30 days pre-HCV diagnosis, adjusted for sex, age, and deprivation.Conclusions: IDUs diagnosed with HCV infection have an increased risk of subsequent hospital admission for an alcohol-related cause. Because of the synergistic effect of HCV infection and excessive alcohol intake on the development of cirrhosis, it is imperative that alcohol intake is addressed in the management of chronic HCV infection in this population. (C) 2010 Elsevier B.V. All rights reserved.",
    keywords = "Alcohol, Hospital admissions, Injecting drug users, Hepatitis C virus, VIRUS-INFECTION, RECURRENT EVENTS, RECORD-LINKAGE, PROGRESSION, HIV, PREVALENCE, MORTALITY, CIRRHOSIS, PATTERNS, RATES",
    author = "McDonald, {Scott A.} and Hutchinson, {Sharon J.} and Bird, {Sheila M.} and Chris Robertson and Mills, {Peter R.} and Dillon, {John F.} and Goldberg, {David J.}",
    year = "2011",
    month = "1",
    doi = "10.1016/j.drugpo.2010.04.003",
    language = "English",
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    Hospitalisation for an alcohol-related cause among injecting drug users in Scotland : increased risk following diagnosis with hepatitis C infection. / McDonald, Scott A.; Hutchinson, Sharon J.; Bird, Sheila M.; Robertson, Chris; Mills, Peter R.; Dillon, John F.; Goldberg, David J.

    In: International Journal of Drug Policy, Vol. 22, No. 1, 01.2011, p. 63-69.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Hospitalisation for an alcohol-related cause among injecting drug users in Scotland

    T2 - increased risk following diagnosis with hepatitis C infection

    AU - McDonald, Scott A.

    AU - Hutchinson, Sharon J.

    AU - Bird, Sheila M.

    AU - Robertson, Chris

    AU - Mills, Peter R.

    AU - Dillon, John F.

    AU - Goldberg, David J.

    PY - 2011/1

    Y1 - 2011/1

    N2 - Background: The rate of hepatitis C (HCV) related liver disease progression is known to be strongly associated with alcohol consumption, yet there are very few data on alcohol use in injecting drug users (IDUs), who represent 90% of Scotland's HCV-diagnosed population. To investigate the extent of alcohol use in IDUs, we used hospitalisation with an alcohol-related diagnosis as an indicator for problematic consumption levels, and compared admission rates pre- and post-HCV diagnosis.Methods: Data for 41,062 current/former IDUs attending drug treatment/support services in Scotland from April 1995 to March 2006 were linked to the national hospital discharge database to retrieve alcohol-related episodes, and to the national HCV Diagnosis database to determine HCV-diagnosed status. Relative risks were estimated using Cox proportional hazards regression for recurrent events.Results: The proportion of IDUs with >= 1 alcohol-related admission following first attendance at drug services was greater among those diagnosed with HCV by the end of follow-up (16%) compared with those who were not (6%). For the 9145 IDUs who had been diagnosed with HCV by 31 March 2006, there was a 1.5-fold increased relative risk of an alcohol-related admission >30 days post-HCV diagnosis (95% Cl: 1.2-1.7) compared with >30 days pre-HCV diagnosis, adjusted for sex, age, and deprivation.Conclusions: IDUs diagnosed with HCV infection have an increased risk of subsequent hospital admission for an alcohol-related cause. Because of the synergistic effect of HCV infection and excessive alcohol intake on the development of cirrhosis, it is imperative that alcohol intake is addressed in the management of chronic HCV infection in this population. (C) 2010 Elsevier B.V. All rights reserved.

    AB - Background: The rate of hepatitis C (HCV) related liver disease progression is known to be strongly associated with alcohol consumption, yet there are very few data on alcohol use in injecting drug users (IDUs), who represent 90% of Scotland's HCV-diagnosed population. To investigate the extent of alcohol use in IDUs, we used hospitalisation with an alcohol-related diagnosis as an indicator for problematic consumption levels, and compared admission rates pre- and post-HCV diagnosis.Methods: Data for 41,062 current/former IDUs attending drug treatment/support services in Scotland from April 1995 to March 2006 were linked to the national hospital discharge database to retrieve alcohol-related episodes, and to the national HCV Diagnosis database to determine HCV-diagnosed status. Relative risks were estimated using Cox proportional hazards regression for recurrent events.Results: The proportion of IDUs with >= 1 alcohol-related admission following first attendance at drug services was greater among those diagnosed with HCV by the end of follow-up (16%) compared with those who were not (6%). For the 9145 IDUs who had been diagnosed with HCV by 31 March 2006, there was a 1.5-fold increased relative risk of an alcohol-related admission >30 days post-HCV diagnosis (95% Cl: 1.2-1.7) compared with >30 days pre-HCV diagnosis, adjusted for sex, age, and deprivation.Conclusions: IDUs diagnosed with HCV infection have an increased risk of subsequent hospital admission for an alcohol-related cause. Because of the synergistic effect of HCV infection and excessive alcohol intake on the development of cirrhosis, it is imperative that alcohol intake is addressed in the management of chronic HCV infection in this population. (C) 2010 Elsevier B.V. All rights reserved.

    KW - Alcohol

    KW - Hospital admissions

    KW - Injecting drug users

    KW - Hepatitis C virus

    KW - VIRUS-INFECTION

    KW - RECURRENT EVENTS

    KW - RECORD-LINKAGE

    KW - PROGRESSION

    KW - HIV

    KW - PREVALENCE

    KW - MORTALITY

    KW - CIRRHOSIS

    KW - PATTERNS

    KW - RATES

    U2 - 10.1016/j.drugpo.2010.04.003

    DO - 10.1016/j.drugpo.2010.04.003

    M3 - Article

    VL - 22

    SP - 63

    EP - 69

    JO - International Journal of Drug Policy

    JF - International Journal of Drug Policy

    SN - 0955-3959

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    ER -