Alcohol consumption is not associated with sustained virologic response to hepatitis C treatment

Among patients starting direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection, alcohol consumption is not associated with a reduced odds of sustained virologic response (SVR), according to a study published online Sept. 17. 26 inches JAMA Network Open.

Emily J. Cartwright, MD, of the Veterans Affairs Medical Center in Atlanta, and colleagues evaluated whether alcohol consumption at the start of DAA treatment was associated with a reduced likelihood of SVR. The analysis included 69,229 patients with chronic HCV infection who initiated DAA therapy between January 1, 2014, and June 30, 2018.

Researchers found that 94.4% of patients achieved SVR. Overall, 46.6% of participants were abstinent without alcohol use disorder (AUD), 13.3% were abstinent with AUD, 19.4% had low-risk drinking, and 4.5% had moderate Risky drinking, 16.2% had high-risk drinking or AUD. There were no differences in SVR across drinking categories, even among patients with high-risk drinking or AUD, after adjusting for other confounders (odds ratio, 0.95; 95% confidence interval, 0.85 to 1.07). Furthermore, there was no interaction between liver fibrosis stage as measured by Fibrosis 4 score.

“These findings suggest that limiting DAA treatment based on alcohol consumption creates unnecessary barriers for patients and challenges hepatitis C elimination goals,” the authors wrote.

One author disclosed links to the pharmaceutical industry.