Sustained Virologic Response in Hepatitis C Treatment May be Similar for Patients Who Drink Alcohol and Those Who Abstain

Alcohol use hastens the progression of liver disease among individuals with chronic Hepatitis C (HCV) infection, but the impact of ongoing alcohol use on efficacy of HCV treatment is unknown. This retrospective analysis of the Swiss Hepatitis C Cohort assessed alcohol use among 554 patients receiving antiviral therapy for hepatitis C. Participants were divided into 3 groups: nondrinkers (81%), those who consumed 1–24 g per day (15%), and those who consumed >24 g (about 2 drinks) per day (1%). Multivariable analyses included HCV genotype, age, body mass index, cirrhosis, medication type, treatment adherence, and drinking level during treatment. The main outcome was a sustained virologic response (SVR) 6 months following treatment.

• Overall, 58% of participants were adherent to antiviral therapy, and 60% achieved SVR.

• The odds of achieving SVR were lower but not significantly so for those consuming 1–24 g per day (odds ratio [OR], 0.50 and those consuming >24 g per day (OR, 0.7) compared with nondrinkers.

Comments:

The retrospective observational design of this analysis limits the strength of the findings, and the small number of participants who drank, particularly those who drank 2 drinks a day, limits the power of the study to detect harms. This limitation is especially important, since the ORs for drinkers were consistent with a lower likelihood of achieving SVR. These findings do suggest that adherence to medication may be the most important factor in HCV treatment success. Ongoing alcohol use need not necessarily preclude an individual from consideration for HCV treatment.

Hillary Kunins, MD, MPH, MS

Reference:

Bruggmann P, Dampz M, Gerlach T, et al. Treatment outcome in relation to alcohol consumption during hepatitis C therapy: an analysis of the Swiss Hepatitis C Cohort Study. Drug Alcohol Depend. 2010;110 (1–2):167–171.