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Research Summary

Brief Alcohol Treatment in a Hepatitis-C Clinic: Results from an Observational Study

The combination of alcohol use and hepatitis-C (HCV) infection is thought to increase the risk for liver cirrhosis, while heavy alcohol use can limit the effectiveness of HCV antiviral therapy. Yet, many patients with HCV drink risky amounts. In this retrospective medical-record review study conducted at an HCV treatment clinic, investigators assessed the impact of a brief integrated alcohol intervention on drinking outcomes and HCV antiviral treatment* eligibility among 47 heavy-drinking men entering HCV treatment. The intervention was delivered by clinicians and followed by a within-clinic referral to a specialized mental health nurse for alcohol treatment. At the time of record review, patients had been followed for 8–22 months.

  • Seventy-two percent of patients who received the intervention agreed to further alcohol treatment.
  • At the last follow-up, 62% of patients reported a >50% drinking reduction, including 36% who achieved abstinence.
  • The mean quantity of drinks per drinking day fell from 9.5 at baseline to 3.8 at the last follow-up (p<0.001).
  • Only 6% of patients were excluded from HCV antiviral treatment because of drinking or drug use.
*Interferon plus ribavirin.
†Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) scores ≥4.

Comments:

This small uncontrolled trial showed that integrating HCV and alcohol treatment is feasible in real-world settings. Within-clinic referral has the potential to improve linkage of patients with alcohol use disorders to specialized treatment who may not otherwise have access to it. This, in turn, could lead to significant decreases in drinking, thus improving HCV antiviral treatment eligibility and slowing disease progression. However, these results cannot be considered definitive until they are replicated in controlled trials. Nicolas Bertholet, MD, MSc

Reference:

Dieperink E, Ho SB, Heit S, et al. Significant reductions in drinking following brief alcohol treatment provided in a hepatitis C clinic. Psychosomatics. 2010;51(2):149–56.

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