Fracture risk in hepatitis C virus infected persons: Results from the DANVIR cohort study

Ann-Brit Eg Hansen; Lars Haukali Omland; Henrik Krarup; Niels Obel; DANVIR Cohort Study

doi:10.1016/j.jhep.2014.03.007

Fracture risk in hepatitis C virus infected persons: Results from the DANVIR cohort study

Ann-Brit Eg Hansen, Lars Haukali Omland, Henrik Krarup, Niels Obel, DANVIR Cohort Study

Department of Clinical Medicine

17 Citations (Scopus)

Abstract

BACKGROUND & AIMS: The association between Hepatitis C virus (HCV)-infection and fracture risk is not well characterized. We compared fracture risk between HCV-seropositive (HCV-exposed) patients and the general population and between patients with cleared and chronic HCV-infection.

METHODS: Outcome measures were time to first fracture at any site, time to first low-energy and first non-low-energy (other) fracture in 12,013 HCV-exposed patients from the DANVIR cohort compared with a general population control cohort (n=60,065) matched by sex and age. Within DANVIR, 4500 patients with chronic HCV-infection and 2656 patients with cleared HCV-infection were studied.

RESULTS: Compared with population controls, HCV-exposed patients had increased overall risk of fracture [adjusted incidence rate ratio (aIRR) 2.15, 95% Confidence Interval (CI) 2.03-2.28], increased risk of low-energy fracture (aIRR 2.13, 95% CI: 1.93-2.35) and of other fracture (aIRR 2.18, 95% CI: 2.02-2.34). Compared with cleared HCV-infection, chronic HCV-infection was not associated with increased risk of fracture at any site (aIRR 1.08, 95% CI: 0.97-1.20), or other fracture (aIRR 1.04, 95% CI: 0.91-1.19). The aIRR for low-energy fracture was 1.20 (95% CI: 0.99-1.44).

CONCLUSIONS: HCV-exposed patients had increased risk of all fracture types. In contrast, overall risk of fracture did not differ between patients with chronic vs. cleared HCV-infection, although chronic HCV-infection might be associated with a small excess risk of low-energy fractures. Our study suggests that fracture risk in HCV-infected patients is multi-factorial and mainly determined by lifestyle-related factors associated with HCV-exposure.

Original language	English
Journal	Journal of Hepatology
Volume	61
Issue number	1
Pages (from-to)	15-21
Number of pages	7
ISSN	0168-8278
DOIs	https://doi.org/10.1016/j.jhep.2014.03.007
Publication status	Published - Jul 2014

Keywords

Adult
Cohort Studies
Denmark
Female
Fractures, Bone
Hepatitis C
Hepatitis C Antibodies
Hepatitis C, Chronic
Humans
Male
Middle Aged
RNA, Viral
Risk Factors
Viremia

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jhep.2014.03.007

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@article{283681d9774a4723af04ed495c804fb6,

title = "Fracture risk in hepatitis C virus infected persons: Results from the DANVIR cohort study",

abstract = "BACKGROUND & AIMS: The association between Hepatitis C virus (HCV)-infection and fracture risk is not well characterized. We compared fracture risk between HCV-seropositive (HCV-exposed) patients and the general population and between patients with cleared and chronic HCV-infection.METHODS: Outcome measures were time to first fracture at any site, time to first low-energy and first non-low-energy (other) fracture in 12,013 HCV-exposed patients from the DANVIR cohort compared with a general population control cohort (n=60,065) matched by sex and age. Within DANVIR, 4500 patients with chronic HCV-infection and 2656 patients with cleared HCV-infection were studied.RESULTS: Compared with population controls, HCV-exposed patients had increased overall risk of fracture [adjusted incidence rate ratio (aIRR) 2.15, 95% Confidence Interval (CI) 2.03-2.28], increased risk of low-energy fracture (aIRR 2.13, 95% CI: 1.93-2.35) and of other fracture (aIRR 2.18, 95% CI: 2.02-2.34). Compared with cleared HCV-infection, chronic HCV-infection was not associated with increased risk of fracture at any site (aIRR 1.08, 95% CI: 0.97-1.20), or other fracture (aIRR 1.04, 95% CI: 0.91-1.19). The aIRR for low-energy fracture was 1.20 (95% CI: 0.99-1.44).CONCLUSIONS: HCV-exposed patients had increased risk of all fracture types. In contrast, overall risk of fracture did not differ between patients with chronic vs. cleared HCV-infection, although chronic HCV-infection might be associated with a small excess risk of low-energy fractures. Our study suggests that fracture risk in HCV-infected patients is multi-factorial and mainly determined by lifestyle-related factors associated with HCV-exposure.",

keywords = "Adult, Cohort Studies, Denmark, Female, Fractures, Bone, Hepatitis C, Hepatitis C Antibodies, Hepatitis C, Chronic, Humans, Male, Middle Aged, RNA, Viral, Risk Factors, Viremia",

author = "Hansen, {Ann-Brit Eg} and Omland, {Lars Haukali} and Henrik Krarup and Niels Obel and {DANVIR Cohort Study}",

year = "2014",

month = jul,

doi = "10.1016/j.jhep.2014.03.007",

language = "English",

volume = "61",

pages = "15--21",

journal = "Journal of Hepatology, Supplement",

issn = "0169-5185",

publisher = "Elsevier",

number = "1",

}

TY - JOUR

T1 - Fracture risk in hepatitis C virus infected persons

T2 - Results from the DANVIR cohort study

AU - Hansen, Ann-Brit Eg

AU - Omland, Lars Haukali

AU - Krarup, Henrik

AU - Obel, Niels

AU - DANVIR Cohort Study

PY - 2014/7

Y1 - 2014/7

N2 - BACKGROUND & AIMS: The association between Hepatitis C virus (HCV)-infection and fracture risk is not well characterized. We compared fracture risk between HCV-seropositive (HCV-exposed) patients and the general population and between patients with cleared and chronic HCV-infection.METHODS: Outcome measures were time to first fracture at any site, time to first low-energy and first non-low-energy (other) fracture in 12,013 HCV-exposed patients from the DANVIR cohort compared with a general population control cohort (n=60,065) matched by sex and age. Within DANVIR, 4500 patients with chronic HCV-infection and 2656 patients with cleared HCV-infection were studied.RESULTS: Compared with population controls, HCV-exposed patients had increased overall risk of fracture [adjusted incidence rate ratio (aIRR) 2.15, 95% Confidence Interval (CI) 2.03-2.28], increased risk of low-energy fracture (aIRR 2.13, 95% CI: 1.93-2.35) and of other fracture (aIRR 2.18, 95% CI: 2.02-2.34). Compared with cleared HCV-infection, chronic HCV-infection was not associated with increased risk of fracture at any site (aIRR 1.08, 95% CI: 0.97-1.20), or other fracture (aIRR 1.04, 95% CI: 0.91-1.19). The aIRR for low-energy fracture was 1.20 (95% CI: 0.99-1.44).CONCLUSIONS: HCV-exposed patients had increased risk of all fracture types. In contrast, overall risk of fracture did not differ between patients with chronic vs. cleared HCV-infection, although chronic HCV-infection might be associated with a small excess risk of low-energy fractures. Our study suggests that fracture risk in HCV-infected patients is multi-factorial and mainly determined by lifestyle-related factors associated with HCV-exposure.

AB - BACKGROUND & AIMS: The association between Hepatitis C virus (HCV)-infection and fracture risk is not well characterized. We compared fracture risk between HCV-seropositive (HCV-exposed) patients and the general population and between patients with cleared and chronic HCV-infection.METHODS: Outcome measures were time to first fracture at any site, time to first low-energy and first non-low-energy (other) fracture in 12,013 HCV-exposed patients from the DANVIR cohort compared with a general population control cohort (n=60,065) matched by sex and age. Within DANVIR, 4500 patients with chronic HCV-infection and 2656 patients with cleared HCV-infection were studied.RESULTS: Compared with population controls, HCV-exposed patients had increased overall risk of fracture [adjusted incidence rate ratio (aIRR) 2.15, 95% Confidence Interval (CI) 2.03-2.28], increased risk of low-energy fracture (aIRR 2.13, 95% CI: 1.93-2.35) and of other fracture (aIRR 2.18, 95% CI: 2.02-2.34). Compared with cleared HCV-infection, chronic HCV-infection was not associated with increased risk of fracture at any site (aIRR 1.08, 95% CI: 0.97-1.20), or other fracture (aIRR 1.04, 95% CI: 0.91-1.19). The aIRR for low-energy fracture was 1.20 (95% CI: 0.99-1.44).CONCLUSIONS: HCV-exposed patients had increased risk of all fracture types. In contrast, overall risk of fracture did not differ between patients with chronic vs. cleared HCV-infection, although chronic HCV-infection might be associated with a small excess risk of low-energy fractures. Our study suggests that fracture risk in HCV-infected patients is multi-factorial and mainly determined by lifestyle-related factors associated with HCV-exposure.

KW - Adult

KW - Cohort Studies

KW - Denmark

KW - Female

KW - Fractures, Bone

KW - Hepatitis C

KW - Hepatitis C Antibodies

KW - Hepatitis C, Chronic

KW - Humans

KW - Male

KW - Middle Aged

KW - RNA, Viral

KW - Risk Factors

KW - Viremia

U2 - 10.1016/j.jhep.2014.03.007

DO - 10.1016/j.jhep.2014.03.007

M3 - Journal article

C2 - 24650694

SN - 0169-5185

VL - 61

SP - 15

EP - 21

JO - Journal of Hepatology, Supplement

JF - Journal of Hepatology, Supplement

IS - 1

ER -

Fracture risk in hepatitis C virus infected persons: Results from the DANVIR cohort study

Abstract

Keywords

UN SDGs

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