Cigarette smoking and hepatic lesions in patients with chronic hepatitis C
Corresponding Author
Fabienne Pessione
Fédération d'Hépato-Gastroentérologie,
Assistance Publique Hôpitaux de Paris, Fédération d'Hépato-Gastroentérologie, Clichy, France. fax: (33) 1-47-39-87-70===Search for more papers by this authorVéronique Duchatelle
Service d'anatomo-pathologie, Hôpital Beaujon, Clichy, France.
Search for more papers by this authorClaude Degott
Service d'anatomo-pathologie, Hôpital Beaujon, Clichy, France.
Search for more papers by this authorCorresponding Author
Fabienne Pessione
Fédération d'Hépato-Gastroentérologie,
Assistance Publique Hôpitaux de Paris, Fédération d'Hépato-Gastroentérologie, Clichy, France. fax: (33) 1-47-39-87-70===Search for more papers by this authorVéronique Duchatelle
Service d'anatomo-pathologie, Hôpital Beaujon, Clichy, France.
Search for more papers by this authorClaude Degott
Service d'anatomo-pathologie, Hôpital Beaujon, Clichy, France.
Search for more papers by this authorAbstract
A possible hepatotoxicity of cigarette smoke has been recently suggested by epidemiological and experimental studies. Our aim was to study the possible relationships between smoking and liver fibrosis and activity in patients with chronic hepatitis C. A cross-sectional study was performed in a group of 310 patients with chronic hepatitis C consecutively hospitalized for their first liver biopsy. The relationships between age, gender, alcohol consumption, route of contamination, tobacco consumption, and Knodell fibrosis and activity scores were examined in univariate, age-adjusted, and multivariate analyses. One hundred and seventy-six patients (57%) were current smokers. Smokers were younger (P < .001), more often of male gender (P = .001), more often alcohol consumers (P = .001), and more often had a history of intravenous drug use (P = .0001) than never smokers. Smoking was related to increased fibrosis and activity scores in age-adjusted (P = .009 and P = .005, respectively) and multivariate analyses (P = .03 and P = .04, respectively). Smoking increases the severity of hepatic lesions in patients with chronic hepatitis C.
References
- 1 Klatsky AL, Armstrong MA. Alcohol, smoking, coffee, and cirrhosis. Am J Epidemiol 1992; 136: 1248–1257.MEDLINE
- 2 Corrao G, Lepore AR, Torchio P, et al. The effect of drinking coffee and smoking cigarettes on the risk of cirrhosis associated with alcohol consumption: a case-control study. Eur J Epidemiol 1994; 10: 657–664.MEDLINE
- 3 Yu M-W, Hsu F-C, Sheen I-S, Chu CM, Lin DY, Chen CJ, Liaw YF. Prospective study of hepatocellular carcinoma and liver cirrhosis in asymptomatic chronic hepatitis B virus carriers. Am J Epidemiol 1997; 145: 1039–1047.MEDLINE
- 4 Pessione F, Ramond M, Peters L, Batel P, Rueff B, Benhamou JP, Erlinger S, et al. Five-year survival predictive factors in 122 patients with alcoholic cirrhosis. Beneficial effect of non-smoking, alcoholic hepatitis and abstinence. Hepatology 1998; 28: 384A(888).
- 5 Knodell RG, Ishak KG, Black WC, et al. Formulation and application of numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology 1981; 1: 431–435.MEDLINE
- 6 Williams GD, Proudfit AH, Quinn EA, Campbell KE. Variations in quantity-frequency measures of alcohol consumption from a general population survey. Addiction 1994; 89: 413–420.MEDLINE
- 7 Searle S. Linear models for unbalanced data. New York: John Wiley & Sons, Inc, 1987.
- 8 McCullagh P. Regression models for ordinal data. Journal of the Royal Statistical Society, Series B. 1980; 42: 109–142.
- 9 SAS Institute Inc., 6.12 version. Cary, NC, USA, 1999.
- 10 Rothman K, Greenland S. Criteria for a confounding factor. Modern Epidemiology. Philadelphia: Lippincott-Raven, 1998; 123–125.
- 11 Pessione F, Degos F, Marcellin P, et al. Effect of alcohol consumption on serum hepatitis C virus RNA and histological lesions in chronic hepatitis C. Hepatology 1998; 27: 1717–1722.MEDLINE
- 12 Roudot-Thoraval F, Bastie A, Pawlotsky J, Dhumeaux D. Epidemiological factors affecting the severity of hepatitis C virus-related liver disease: a French survey of 6664 patients. Hepatology 1997; 26: 485–490.MEDLINE
- 13 Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. Lancet 1997; 349: 825–832.MEDLINE
- 14 Mori M, Hara M, Wada I, Hara T, Yamamoto K, Honda M, Naramoto J. Prospective study of hepatitis B and C viral infections, cigarette smoking, alcohol consumption and other factors associated with hepatocellular carcinoma risk in Japan. Am J Epidemiol 2000; 151: 131–139.MEDLINE
- 15 Mukaiya M, Nishi M, Miyake H, Hirata K. Chronic liver diseases for the risk of hepatocellular carcinoma: a case-control study in Japan. Etiologic association of alcohol consumption, cigarette smoking and the development of chronic liver diseases. Hepato-Gastroenterology 1998; 45: 2328–2332.
- 16 Yu MW, Chiu YH, Yang SY, et al. Cytochrome P450 1A1 genetic polymorphisms and risk of hepatocellular carcinoma among chronic hepatitis B carriers. Br J Cancer 1999; 80: 598–603.MEDLINE
- 17 Yildiz D, Ercal N, Armstrong DW. Nicotine enantiomers and oxidative stress. Toxicology 1998; 130: 155–165.MEDLINE
- 18 Weitberg A, Corvese D. Oxygen radicals potentiate the genetic toxicity of tobacco-specific nitrosamines. Clin Genet 1993; 43: 88–91.MEDLINE
- 19 Daret K, ST. Clair, Jordan JA, Wan S, Gairola CG. Protective role of manganese superoxide dismutase against cigarette smoke-induced cytotoxicity. J Toxicol Environ Health 1994; 43: 239–249.MEDLINE
- 20 Miro O, Alonso JR, Jarreta D, Casdademont J, Urbano-Marquez A, Cardellach F. Smoking disturbs mitochondrial respiratory chain function and enhances lipid peroxidation on human circulating lymphocytes. Carcinogenesis 1999; 20: 1331–1336.MEDLINE
- 21 Liu CS, Wei Y-H. Age-Associated Alteration of Blood Thiol-Group-Related Antioxidants in Smokers. Environ Res Section A 1999; 80: 18–24.
- 22 Heitzer T, Just H, Münzel T. Antioxidant vitamin C improves endothelial dysfunction in chronic smokers. Circulation 1996; 94: 6–9.MEDLINE
- 23 Lee H-C, Lim MLR, Lu C-Y, Liu VW, Fahn HJ, Zhang C, Nagley P, et al. Concurrent increase of oxidative DNA damage and lipid peroxidation together with mitochondrial DNA mutation in human lung tissues during aging—smoking enhances oxidative stress on the aged tissues. Arch Biochem Biophys 1999; 362: 309–316.MEDLINE
- 24 Balansky R, Izzoti A, Scatolini L, D'Agostini F, De Flora S. Induction by carcinogens and chemoprevention by N-acetylcysteine of adducts to mitochondrial DNA in rat organs. Cancer Res 1996; 56: 1642–1647.MEDLINE
- 25 Bölükbas ÖZ, Kabasakal G, Keyer Uysal M, Peker Ö, Övüne O. Hepatocyte damage caused by nicotine alone and in combination with alcohol. Gastroenterology 1998; 114 ( 4–L0493).
- 26 Geng Y, Savage SM, Razani-Boroujerdi S, Sopori ML. Effects of nicotine on the immune response. II. Chronic nicotine treatment induces T cell anergy. J Immunol 1996; 156: 2384–2390.MEDLINE