RECENT research has shown that alcohol use during the early stages of direct-acting antiviral treatment was not linked to reduced odds for achieving sustained virologic response (SVR) in patients with chronic hepatitis C virus (HCV) infection. “For patients who successfully completed interferon-based therapy, comparable rates of sustained virologic response were achieved regardless of reported alcohol use,” reported Emily J. Cartwright, Emory University School of Medicine, Atlanta, Georgia, USA, and Atlanta Veterans Affairs Medical Center, Decatur, Georgia, USA.
Cartwright and colleagues carried out a retrospective cohort study using national Veterans Affairs data to investigate the association between alcohol use and SVR. They analysed results from 69,229 adults with HCV infection from the 1945–1965 birth cohort (mean age: 62.6 years; 97.0% men; 84.5% HCV genotype 1). Of the cohort, 46.6% were abstinent without alcohol-use disorder (AUD), 13.3% abstinent with AUD, 19.4% lower-risk consumption, 4.5% moderate-risk consumption, and 16.2% high-risk consumption or AUD. Additionally, 50.6% of patients had Fibrosis-4 (FIB-4) scores between 1.45–3.25, 26.1% had scores greater than 3.25, and 23.3% had scores less than 1.45.
The results demonstrated that 94.4% of patients who began direct-acting antiviral therapy achieved SVR. Of these SVR outcomes, 58,651 patients were measured 12 weeks–6 months after completing their treatment, and 6,704 patients were measured at 4–12 weeks. Before adjusting the analysis, the researchers found that patients who were abstinent without history of AUD (odds ratio [OR]: 0.89; 95% confidence interval [CI]: 0.81–0.97) or with history of AUD (OR: 0.71; 95% CI: 0.64–0.80) had decreased odds of achieving SVR compared with those who reported lower-risk consumption.
This result changed, however, after fully adjusting for demographics, clinical characteristics, and liver-related and treatment-related variables. The researchers found that there was no evidence to link alcohol consumption to achieving SVR. Both moderate- (OR: 0.96; 95% CI:0.80–1.15) and high-risk consumption (OR: 0.95; 95% CI: 0.85–1.07) had no impact on SVR. “Our findings suggest that DAA therapy should be provided and reimbursed despite alcohol consumption or history of AUD,” the team concluded.
