Management practices of hepatitis C virus infected alcoholic hepatitis patients: A survey of physicians

Table 1 Respondent variables and responses on each question n (%)

Question	n (%)	DNK	P value
Age (yr)			0.190
< 35	85 (21)
35-44	114 (27)
45-54	112 (27)
55-64	105 (25)
Specialty			0.028
Gastroenterology	232 (56)
Hepatology	184 (44)
Patients (n per year)		23 (5)	< 0.001
< 10	141 (34)
11-20	160 (38)
≥ 20	92 (23)
Percent admitted to hospital		39 (9)	< 0.001
< 25%	46 (12)
26%-50%	74 (18)
51%-75%	94 (23)
>75%	163 (38)
Of admitted, percent through ER		44 (12)	< 0.001
< 50%	81 (19)
51%-75%	69 (16)
> 75%	222 (53)
Percent needing liver biopsy for diagnosis		48 (12)	< 0.001
< 25%	318 (76)
26%-50%	29 (7)
> 50%	21 (5)
Test AAH patients for HCV		53 (13)	< 0.001
Yes	341 (82)
No	22 (5)
Percent positive for HCV		58 (14)	0.015
< 20%	156 (37)
≥ 20%	202 (49)
Treatment for AH			< 0.001
Often	283 (68)
Rarely	114 (27)
Never	19 (5)
Drug preference for treatment			< 0.001
Corticosteroids	197 (47)
Pentoxifylline	150 (37)
Combination	60 (14)
No preference	9 (2)
What makes you choose Pentoxifylline			> 0.05
Infection or sepsis	300 (72)
GI bleeding	161
Renal failure	125
Hepatitis B	139
Hepatitis C	94 (23)
Change in treatment policy with HCV		84 (20)	< 0.001
Yes	83 (20)
No	249 (60)
Treatment preference with concurrent HCV		79 (19)	< 0.001
Corticosteroids	14 (3)
Pentoxifylline	114 (27)
Either	21 (5)
Same as without HCV	180 (44)
No treatment	8 (2)
Does HCV alter outcome of AAH		80 (19)	0.510
No	174 (42)
Worse	161 (39)
Better	1 (0.2)
Does HCV affect treatment response with CS		87 (21)	< 0.001
No	262 (63)
Worse	65 (16)
Better	2 (0.4)
Does HCV affect treatment response with PTX		90 (22)	< 0.001
No	297 (71)
Worse	3 (0.7)
Better	26 (6)

ER: Emergency room; HCV: Hepatitis C virus; AH: Alcoholic hepatitis; CS: Corticosteroids; GI: Gastrointestinal; PTX: Pentraxin; AAH: Acute alcoholic hepatitis.

Table 2 Effect of respondent variables on proportion of respondents being in consensus on each of the four specific questions related to management of hepatitis C virus infected alcoholic hepatitis patients

Respondent variable	Routine screening for HCV			HCV does not change treatment approach			HCV does not affect response to corticosteroids			HCV does not affect treatmentresponse to pentoxifylline
	n (%)	P value	OR (95%CI)	n (%)	P value	OR (95%CI)	n (%)	P value	OR (95%CI)	n (%)	P value	OR (95%CI)
Age (yr) < 35 35-44 45-54 ≥ 55		0.2			0.7			0.8			0.75
	68 (92)		1	51 (76)		1	54 (83)		1	59 (91)		1
	85 (90)		0.8 (0.3-2.5)	66 (73)		1.3 (0.6-3)	69 (77)		0.6 (0.3-1.3)	79 (89)		0.9 (0.3-2.8)
	99 (96)		2.1 (0.5-8)	73 (78)		0.9 (0.4-2)	75 (81)		0.7 (0.3-1.6)	85 (93)		1.7 (0.5-6)
	88 (97)		2.5 (0.6-11)	58 (72)		1.4 (0.6-3)	63 (79)		0.6 (0.3-1.5)	73 (91)		1.3 (0.4-4.2)
Specialty GE HP		0.37			0.5			0.2			0.55
	183 (93)		1	135 (73)		1	135 (77)		1	160 (92)		1
	157 (95)		1.5 (0.6-3.7)	113 (77)		0.8 (0.5-1.4)	126 (83)		0.7 (0.4-1.2)	136 (90)		1.3 (0.6-2.7)
Patients (n/yr) < 30 ≥ 30		0.29			0.6			0.2			0.38
	299 (93)		1	221 (75)		1	232 (81)		1	259 (91)		1
	41 (98)		2.9 (0.4-22.0)	27 (71)		1.3 (0.6-2.7)	29 (73)		1.6 (0.7-3.3)	37 (95)		0.5 (0.1-2.3)
HCV prevalence < 20% ≥ 20%		0.48			0.3			0.2			0.81
	148 (95)		0.7 (0.3-1.8)	104 (72)		0.8 (0.5-1.3)	119 (83)		1.4 (0.8-2.5)	129 (91)		1.1 (0.5-2.4)
	188 (93)		1	143 (77)		1	141 (77)		1	166 (91)		1

HCV: Hepatitis C virus; GE: Gastroenterology; HP: Hepatology. Also shown are results of logistic regression analyses for each respondent variable given as odds ratio (OR) with 95% confidence interval (CI).

Table 3 Effect of respondent variables on proportion of respondents being in consensus on all four questions related to management of hepatitis C virus infected alcoholic hepatitis patients

Respondentvariable	Consensus on all four questions related tomanagement of HCV infected AH patients
	n (%)	P value	OR (95%CI)
Age (yr)
< 35	37 (44)		1
35-44	52 (46)		0.9 (0.5-1.8)
45-54	58 (53)	0.2	1.1 (0.6-3.1)
≥ 55	44 (43)		1.9 (0.5-4.3)
Specialty
GE	125 (56)		1
HP	84 (47)	0.37	1.4 (0.97-2.1)
Patients (n/yr)
< 30	180 (52)		1
≥ 30	22 (49)	0.29	1.1 (0.6-2.1)
HCV prevalence
< 20%	71 (46)	0.48	0.9 (0.6-1.4)
≥ 20%	97 (48)		1

HCV: Hepatitis C virus; GE: Gastroenterology; HP: Hepatology; AH: Alcoholic hepatitis. Also shown are results of logistic regression analysis for each respondent variable given as odds ratio (OR) with 95% confidence interval (CI).