AASLD LIVER MEETING
- Source: Abstract # 911
Alcohol use and hepatitis C virus treatment outcomes among 15,151 patients receiving direct antiviral agents—J Tsui et. al
Alcohol and hepatitis C treatment has always been a thorny issue. The current study examined the association between alcohol use and antiviral treatment. The study was conducted in the Veterans Affairs (VA) healthcare system during January 01, 2014 through June 30, 2015. The tool used to screen for alcohol consumption was the Alcohol Use Disorder Identification Consumption (AUDIT-C) questionnaire within the one-year before starting treatment. During the study period, 17,487 Veterans initiated DAA therapy. Of those 15,151 (87%) had completed the AUDIT-C questionnaire within one year. The antiviral therapies included sofosbuvir, sofosbuvir/ledipasvir (Harvoni) or Vikiera-Pak.
AUDIT-C scores categorized as follows: 0 (abstinence), 1-3 (low-level drinking) and 4-12 (unhealthy drinking) in men or 0, 1-2 and 3-12 in women.
The patient population was mostly male (96.7%), 28.9% were black, 30% had cirrhosis, mean age was 61 ±7 years and the distribution of HCV genotypes was 1 (79.8%), 2 (12.5%), 3 (7.0%) and 4 (0.8%).
Alcohol abstinence was reported in 10,387 (68.5%) patients, low-level drinking in 3422 (22.6%) patients, and unhealthy drinking in 1342 (8.9%) patients.
Conclusion: The SVR/cure rate was: abstinent group: 91%; low-level group: 93%; unhealthy drinking 91%. Additionally, HCV genotype, cirrhosis, or HIV status was not associated with SVR. Alcohol use had no effect on cure rates in the people who used alcohol or in those who did not.
Editorial Comments: This study is a large population-based study that proves that drinking alcohol does not lower the chances of achieving an SVR/CURE. For this reason, people with hepatitis C should not be denied treatment just because they consume alcohol. It’s as simple as that, and we should take out the moral judgment that frequently taints the decision-making process of who receives treatment and who doesn’t. (For related content, see Lucinda K. Porter’s coverage of abstract #17691)
Alan Franciscus is the Executive Director of the Hepatitis C Support Project and the Editor-in-Chief of the HCV Advocate Website.