Clinical

Alcohol users often considered ineligible for HCV treatment

Last Updated: 2006-06-21 12:32:30 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Past and recent alcohol use is associated with reduced eligibility for hepatitis C virus (HCV) treatment, according to researchers. However, past and current alcohol drinkers who complete treatment have responses that are comparable to non-drinkers.

Dr. Bhupinder S. Anand, of the Michael E. DeBakey VA Medical Center, Houston, and colleagues examined the effect of alcohol use on HCV treatment outcomes. Patients were divided into the following categories: drinkers versus non-drinkers; quantity of alcohol consumed (none, less than 6 drinks/day, 6 or more drinks/day); CAGE score (less than 2 or 2 or higher); and recent alcohol use (past 12 months).

Seven hundred twenty-six subjects (18%) were treated with interferon plus ribavirin, including 142 nondrinkers and 584 drinkers. The results of the study are published in the May issue of Gastroenterology.

A total of 218 patients (30%) were HCV polymerase chain reaction negative at the end of treatment. Of these, 12% had a virologic relapse after discontinuation of therapy, resulting in an overall sustained virologic response of 18%. End-of-treatment, sustained virologic response, and treatment discontinuation rates were not affected by past alcohol use.

Forty percent of recent drinkers discontinued treatment early, compared with 26% of non-drinkers (p < 0.0002). Recent alcohol use also tended to reduce the sustained virologic response. However, when the team excluded patients who discontinued treatment, the trend in favor of non-drinkers for sustained virologic response disappeared.

"These findings were consistent among the subgroups of genotype 1 and black patients," Dr. Anand's team adds. "Our observations are clinically important because they indicate that alcohol use should not be considered an exclusion criterion when evaluating patients for anti-HCV treatment, especially in view of the fact that nearly one third of patients with HCV infection have a history of recent alcohol use."

Gastroenterology 2006;130:1607-1616.