Knowledge of Positive HCV Status Reduced Alcohol Consumption in People with Injection Drug Use
Patients infected with hepatitis C virus (HCV) are encouraged to abstain from drinking, as heavy alcohol use increases the risk of end-stage liver disease and decreases the likelihood of response to HCV antiviral therapy. Investigators in Glasgow, Scotland, performed a cross-sectional survey to determine whether people with injection drug use (IDU) attending harm-reduction services adhered to lower risk drinking guidelines. Ninety-seven percent of respondents (n=780) provided an anonymous oral fluid sample for HCV detection.
- Of those who submitted fluid samples, 506 (65%) tested positive for HCV; 277 of those who tested positive were unaware of their HCV status or had self-reported as HCV-negative.
- Among participants who tested positive, 65% drank alcohol, and 29% drank risky amounts.*
- Among participants who tested negative, 61% drank alcohol, and 18% drank risky amounts.
- People with IDU who self-reported being infected with HCV were less likely to drink than those who self-reported as HCV negative or “status not known” (adjusted odd ratio, 0.70).
- The proportion of participants who drank any amount was lower than that in the Scottish general population; however, the proportion who drank risky amounts was similar to that in the general population among men and slightly higher among women.
*Defined in this study as >14 (8 g ethanol) units per week for women and >21 units per week for men.
Comments:This cross-sectional study found a high proportion of HCV-infected patients with IDU in Scotland not only drink but also drink risky amounts, putting themselves at increased risk for end-stage liver disease and death. Furthermore, many people with IDU were unaware of their HCV status, while those who were aware drank less than others. These results stress the need to implement measures aimed at detecting HCV infection in people with IDU and making them aware of the risks associated with alcohol consumption. Daniel Fuster, MD, PhD,** & Richard Saitz, MD, MPH
**Contributing Editorial Intern and Research Scholar, Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA.