Behavioral Intervention Associated with Improved Liver Enzymes in HCV-infected Young People Who Use Injection Drugs
This secondary analysis of data from the Study to Reduce Intravenous Exposures (STRIVE) randomized clinical trial assessed the effect of an educational/behavioral intervention on self-reported drinking and liver enzymes (AST/ALT*) in 355 young (aged 18–35) HCV-infected patients with prior 6-month injection drug use (IDU). The intervention included multiple group sessions about HCV/liver-related health including alcohol, whereas the control arm participated in general discussions about various social issues (family, self-respect, etc.). Data from baseline, 3-, and 6-month follow-up visits were analyzed.
- The intervention was associated with lower AST (odds ratio [OR]=0.91, p=0.06) and ALT (OR=0.94, p=0.05) at 6 months but had no effect on alcohol use or AUDIT† score.
- Patterns of self-reported alcohol use were dynamic, with frequent transitions from use to abstinence and vice versa. Transitions were significantly associated with changes in AST/ALT.
- Subjects who had received a clinical diagnosis of liver disease were more likely to transition to abstinence (relative risk, 1.88).
*AST=aspartate aminotransferase; ALT=alanine aminotransferase.
†AUDIT=Alcohol Use Disorders Identification Test.