Liver cirrhosis among females with cystic fibrosis using hormonal contraception.

OBJECTIVE

We assessed incidence of liver cirrhosis, risk factors for developing cirrhosis, and if there is an association between hormonal contraception (HC) use and liver cirrhosis among reproductive-aged females with cystic fibrosis (CF).

STUDY

DESIGN

Between January 2021 and April 2022, we recruited reproductive-aged females with CF to complete a questionnaire. We linked their responses to the Cystic Fibrosis Foundation Patient Registry (CFFPR) to examine potential risk factors for incident liver cirrhosis and its association with time-varying HC using survival analysis.

RESULTS

Among 551 persons with CFFPR survey and registry data, 8 had cirrhosis at first available registry report and 3 were excluded for other reasons. Of the 540 remaining participants, 250 (46.3%) were F508 homozygous, 437 (80.9%) were using modulators, and 28 (5.2%) had new onset cirrhosis. Genotype and modulator use were not associated with cirrhosis incidence (adjusted hazard ratios (aHR) 0.57 with 95% confidence interval (CI) 0.15-2.22 and 0.86 with CI 0.24-3.11, respectively). Over all 5146 years of reporting including a median of 12 years per person, 64.9% of years involved reported non-HC, 23.6% combined HC, and 11.5% progestin-only HC. HC use was not associated with cirrhosis incidence (aHR 0.68 with CI 0.25-1.86 for combined HC and 0.57 with CI 0.13-2.49 for progestin-only HC).

CONCLUSION

In our observational cohort, the incidence of cirrhosis was 5.2%. HC use is not associated with liver cirrhosis. Future research should explore the risk factors in CF for developing liver cirrhosis and its relation with HC use.

IMPLICATIONS: In females with cystic fibrosis, hormonal contraception is not associated with liver cirrhosis.