Injection-Drug and Heavy Alcohol Use Did Not Affect Hepatitis-C Treatment Outcomes in an Australian Study
Clinical trials have demonstrated the efficacy of interferon-based therapies for treatment of chronic hepatitis C virus (HCV) infection, but such studies often exclude patients with alcohol- and drug-related problems. This prospective observational cohort study recruited HCV-infected patients from 24 HCV clinics in a variety of settings, including drug-treatment and correctional centers, throughout Australia. Analyses focused on 550 treatment-naïve patients recruited between 2008–2009 who subsequently underwent treatment for HCV with pegylated-interferon and ribavirin. The median age was 46; the majority were male (63%) and had a history of prior injection drug use (68%), though few (5%) had current injection drug use. Thirty-five patients (6.4%) had current heavy alcohol use.* The primary viral genotypes were 1 and 3 (50% and 42%, respectively). The median duration of infection was 19 years (interquartile range, 10–27 years).
- Among all patients who received at least 1 dose of interferon, sustained viral response (SVR) was achieved in 60% of patients overall (50% for genotype 1 and 70% for genotypes 2 and 3). Ten percent of patients discontinued early due to nonresponse, and 10% discontinued due to adverse events or side effects.
- In the multivariable analysis, there was no significant association between SVR and past injection drug use (OR=1.67), current injection drug use (OR=0.72), or current heavy alcohol use (OR=1.10).
*Defined as >20 g per day in this study.