Source

PIRE Prevention Research Center, Berkeley, CA. russell@prev.org.

Abstract

Treatment of chronic hepatitis C infection (HCV+) has historically been shown to be less effective in patients with a heavy drinking history. The effect of moderate and heavy alcohol use on treatment with pegylated interferon alpha and ribavirin (P/R) in an insured household population has not been previously reported. We investigated the effect of alcohol on treatment outcome in a cohort of 421 treatment naïve HCV+ patients, members of an integrated health care plan treated with P/R between January 2002 and June 2008. A detailed drinking history was obtained for 259 (61.5%) eligible patients. Regular drinking was reported by 93.1% of patients prior to HCV diagnosis, by 30.9% between HCV diagnosis and treatment, by 1.9% during treatment, and 11.6% after the end of treatment. Heavy drinking patterns were reported by 67.9%; 63.5% of patients drank more than 100 kg of ethanol prior to initiating HCV treatment; and 29.3% reported abstaining less than the required six months prior to treatment. Despite these reports of heavy drinking, SVRs were obtained in 80.2% of patients with HCV genotype 2/3 and 45.1% of patients with genotype 1/4/6. Pretreatment drinking patterns and total alcohol intake were both unrelated to SVR rates. Abstaining less than six months prior to treatment was related to lower SVR rates in moderate, but not heavy drinkers. HCV treatment relapse was unrelated to drinking after treatment ended. CONCLUSION: The amount of alcohol consumed prior to HCV treatment did not have a negative impact on treatment outcomes in our population. A history of heavy drinking should not be considered a deterrent to HCV treatment in members of an integrated health care plan who are closely monitored.