1Division of Gastroenterology, Toronto General Hospital, University Health Network, Toronto, Canada.
2 Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States.
3 Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, United States.
4 Division of Gastroenterology, Toronto General Hospital, University Health Network, Toronto, Canada; IHPME, University of Toronto, Toronto, Canada.
5 Division of Gastroenterology and Hepatology, University of California-San Francisco, San Francisco, CA, United States.
6 Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, United States.
7 Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States.
8 Division of Gastroenterology, Toronto General Hospital, University Health Network, Toronto, Canada. Electronic address: Harry.Janssen@uhn.ca.
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.