Alcohol use high among hepatitis C virus patients

Alcohol accelerates liver damage in people living with hepatitis C virus (HCV) infections, according to a new national household study of U.S. adults.

The study shows that many people infected with HCV report either former or current excessive alcohol use. People living with HCV were three times more likely to drink five or more drinks per day every day at some point in their lives than those without HCV infections.

The researchers published their results in the August 2016 issue of American Journal of Preventive Medicine.

Alcohol use has been identified as a primary predictor in the progression of complications associated with chronic HCV infection, including cirrhosis and hepatocellular carcinoma.   

“People with chronic hepatitis C should avoid alcohol because it can cause additional liver damage. They also should check with a health professional before taking any prescription pills, supplements, or over-the-counter medications, as these can potentially damage the liver,” lead author Amber L. Taylor, MPH, from the Centers for Disease Control and Prevention's Division of Viral Hepatitis, told Medical Economics.

Alcohol promotes faster development of fibrosis and progression to cirrhosis in people living with HCV, said Taylor, who noted that in 2010, alcohol-related liver disease ranked third as a cause of death among people with hepatitis C.

Taylor and colleagues examined self-reported alcohol use in relation to HCV status using information from 20,042 participants in the National Health and Nutrition Examination Survey (NHANES). They looked at HCV infection rates for four groups: lifetime abstainers, former drinkers, non-excessive current drinkers, and excessive current drinkers.

The results show a higher prevalence of HCV among former drinkers (2.2%) and excessive current drinkers (1.5%) than lifetime abstainers (0.4%) or current non-excessive drinkers (0.9%). Controlling for age, sex, race/ethnicity, education, and having a usual source of health care, HCV infection was significantly associated with excessive current drinking and former drinking.

A follow-up survey of people who participated in NHANES 2001-2008 and who tested positive for HCV antibodies found that 50% were unaware of their HCV status before being notified of their positive test by NHANES. This mirrors the national trend.

"Half of all people living with hepatitis C are not aware of their infection nor the serious medical risks they face when consuming alcohol," said Taylor. "This highlights the need for increased diagnosis as well as comprehensive and effective interventions to link hepatitis C-infected individuals to curative treatments now available and provide education and support needed to reduce alcohol use."

The study helps shed more light on the level of alcohol consumption among those living with HCV and can help guide best practices for both treating patients and steering possible interventions, she said.

"The implementation of behavioral screenings to identify at-risk drinking among both hepatitis C-infected and uninfected individuals could prevent alcohol abuse and serve as a platform to educate patients on the associated risks," said Taylor. "Targeted strategies should emphasize testing to increase hepatitis C awareness among undiagnosed people, prevent disease progression, and ultimately link those infected to curative lifesaving treatments."