Consumption of alcohol by patients with HCV: Empirically informed recommendations

Background.  The clinical complexities of alcohol consumption patterns in patients with hepatitis C (HCV) are largely unexamined.  Commonly held assumptions about alcohol use in patients seeking HCV treatment remain empirically untested.  The purpose of this study is to examine alcohol consumption patterns among these patients, describing and comparing groups of patients with and without alcohol use disorders and current and lifetime alcohol use histories.

Methods.  Patients with hepatitis C considering antiviral  treatment (N=309) were recruited from university-affiliated and VA liver and infectious disease clinics and assessed for psychiatric disorders and alcohol use patterns.

Results.  More than one-half of the sample reported alcohol use in the last year, despite reporting being educated about the potential clinical harm associated with any consumption.  Patients without alcohol use in the last year largely resembled those with no lifetime alcohol use.  Compared to patients still using alcohol, those no longer using alcohol were less likely to have current substance use disorder or drug use, and had fewer current risky behaviors.  Among patients using alcohol in the last year, those with past history of alcohol use disorder differed from those without only by more positive drug use variables.

Discussion. Continuing use of alcohol by patients with HCV, regardless of alcohol use disorder history, has the potential to worsen the liver damage with potential progression to end-stage liver disease and death.  Assessment and monitoring of all HCV patients for alcohol use, and treatment for those continuing to consume, is important before, during, and after HCV treatment.