Alcohol Use Disorder and Progression of Liver Disease Among People With HCV

This systematic review and meta-analysis aimed to summarize the evidence on the association between alcohol use disorder (AUD) and decompensated liver cirrhosis among people with chronic hepatitis C (HCV) infection. Using data from 268,114 people with chronic HCV in France, researchers identified the prevalence of AUD and its association with decompensated liver cirrhosis.

• Prevalence of AUD in the cohort was 24%.
• Prevalence of decompensated liver cirrhosis was 8%.
• AUD was associated with an increased risk of progression to decompensated liver cirrhosis* (relative risk, 3.3).
• 35% of decompensated liver disease cases were attributable to AUD.

* Defined as: acute deterioration in liver function in patients with liver cirrhosis, characterized by jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome, and/or variceal hemorrhage.

Comments: Among this cohort of people with HCV infection in France, the prevalence of AUD was elevated, accounting for more than a third of cases of decompensated liver cirrhosis. Alcohol use should be assessed among patients with liver disease and reduction in alcohol use and/or treatment for AUD should be supported. This study also points to the need for data from regions of the world with high HCV infection prevalence (e.g., Africa, Central Asia, and Eastern Europe).

Nicolas Bertholet, MD, MSc

Reference: Llamosas-Falcón L, Shield KD, Gelovany M, et al. Alcohol use disorders and the risk of progression of liver disease in people with hepatitis C virus infection – a systematic review. Subst Abuse Treat Prev Policy. 2020;15(1):45.