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Research Summary

Pretreatment Alcohol Intake and Duration of Pretreatment Abstinence Do Not Impact HCV Treatment Outcomes

Prior studies of alcohol consumption and HCV treatment suggest current and past heavy drinking are associated with treatment failure, which may provide a rationale for withholding HCV treatment or requiring pretreatment abstinence from patients with heavy alcohol use. This retrospective observational study evaluated the relationship between pretreatment alcohol intake and sustained virologic response (SVR) in a cohort of privately insured patients who initiated HCV treatment between 2002 and 2008. Eligible participants* underwent a retrospective assessment of lifetime drinking patterns, which was used to calculate total alcohol consumption (kg) prior to treatment. Multivariable logistic regression analyses adjusted for demographic and viral-related factors.

  • Of 421 patients eligible for the study, only 259 (62%) completed study interviews.
  • There was no significant association between pretreatment alcohol intake and failure to achieve SVR (adjusted odds ratio [AOR], 1.00).
  • There was no significant association between months of abstinence leading up to treatment and failure to achieve SVR (AOR, 0.998).
*Reasons for ineligibility included the following: not treatment-naïve; left health plan; died; post-transplant; coinfection with HBV or HIV; non-English speaking; too ill; provider recommendation not to participate.

Comments:

This study did not find an association between total lifetime alcohol intake or duration of pretreatment abstinence and HCV treatment failure. Study strengths included a large sample size and detailed measurement of alcohol use. Limitations included a large number of patients who were either ineligible or did not complete the study interview (potential to introduce bias) and a retrospective study design. Nevertheless, results suggest prior heavy alcohol use should not be viewed as a barrier to HCV treatment. Judith Tsui, MD, MPH

Reference:

Russell M, Pauly MP, Moore CD, et al. The impact of lifetime alcohol use on hepatitis C treatment outcomes in privately insured members of an integrated health care plan. Hepatology. 2012;56(4):1223–1230.

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