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Liver Int. 2019 Mar 25. doi: 10.1111/liv.14105. [Epub ahead of print]

Prevalence and predictors of complementary and alternative medicine modalities in patients with chronic hepatitis B.

Author information

1
Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Canada.
2
Department of Gastroenterology and Hepatology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
3
McLaughlin-Rotman Centre for Global Health, Toronto, Canada.
4
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.

Abstract

BACKGROUND & AIMS:

The use of complementary and alternative medicine (CAM) in patients with chronic hepatitis B (CHB) can interact with antiviral treatment or influence health-seeking behaviour. We aimed to study the use of individual CAM modalities in CHB and explore determinants of use, particularly migration-related, socio-economic and clinical factors.

METHODS:

A total of 436 CHB outpatients who attended the Toronto Centre for Liver Disease in 2015-2016 were included in this cross-sectional study. Using the comprehensive I-CAM questionnaire and health records, data were collected on socio-demographic and clinical variables and on usage of 16 CAM modalities in the last year.

RESULTS:

Sixty percent of patients were male, 74% were Asian and 46% were using antiviral treatment. Three-hundred and nine (71%) patients used CAM. Vitamin/mineral preparations (45% of patients) were most commonly used. Overall CAM use and the specific use of potentially injurious CAM, such as green tea extract (9.2%) and St. John's wort (0.2%), were not associated with liver disease severity. Female sex, family history of CHB, lower serum HBV DNA, and higher socio-economic status were independently associated with bio-holistic CAM use, the clinically most-relevant CAM group (P < 0.05); ethnicity, antiviral therapy use and liver disease severity were not.

CONCLUSIONS:

CAM use among CHB patients was extensive, especially use of vitamin and mineral preparations, but without direct influence on liver disease severity. Bio-holistic CAM use appeared to be associated with socio-economic status rather than with ethnicity or liver disease severity. Despite the rare use of hepatotoxins, physicians should actively inquire about it.

KEYWORDS:

chronic hepatitis B; complementary and alternative medicine; ethnicity; hepatotoxicity

PMID:
30912219
DOI:
10.1111/liv.14105

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