HealthWise – AASLD 2016
Abstract #1769 Alcohol Use Disorder Among Chronic Hepatitis C Patients: Prevalence and Treatment Outcome, CHeCS, 2006-2013 – Eyasu H. Teshale
People with hep C are advised to avoid alcohol use. Alcohol increases the risk of liver damage, and it may create HCV treatment-related barriers. This study examines the prevalence of alcohol use and subsequent treatment barriers in HCV patients. Data were collected from 11,636 HCV patients seen at four large U.S. healthcare systems from 2006-2013. Note that these dates are before the approval of highly effective, all oral DAA regimens.
Approximately 40% of subjects received HCV treatment. Approximately 30% of HCV patients had one or more alcohol-related diagnoses, but only 50% of those with alcohol-related liver disease received treatment. The treatment rate dropped to 30% among those who were diagnosed with alcohol abuse. Treatment response rates (SVRs) were 41.6% overall, 44.7% for those with alcohol abuse, and 28.4% for those with alcohol-related liver disease.
Conclusion: Controlling for age, gender, race, and household income, persons with alcohol abuse were less likely to receive HCV treatment. Those with alcohol-related liver disease were more likely to receive treatment than those with no alcohol use disorder. The use of direct acting antiviral therapy may improve the likelihood of treatment and outcomes among all patients, including those with an alcohol use disorder.
Editorial Comments: Alcohol and drug use should not be barriers to HCV treatment. In fact, the only reason to deny HCV treatment is if someone is likely to die within a year from a disease unrelated to hepatitis C. (For related content, see Alan Franciscus’s coverage of #911.)
Lucinda K. Porter, RN, is a long-time contributor to the HCV Advocate and author of “Free from Hepatitis C” and “Hepatitis C One Step at a Time.” She blogs at www.LucindaPorterRN.com and HepMag.com
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