1. The impact of lifetime alcohol use on hepatitis C treatment outcomes in privately insured members of an integrated health care plan.
- Author
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Russell M, Pauly MP, Moore CD, Chia C, Dorrell J, Cunanan RJ, Witt G, and Martin S
- Subjects
- Adult, Aged, Alcohol Drinking economics, Antiviral Agents economics, Antiviral Agents therapeutic use, California, Cohort Studies, Confidence Intervals, Drug Therapy, Combination, Female, Follow-Up Studies, Hepatitis C diagnosis, Hepatitis C economics, Humans, Insurance, Health economics, Interferon-alpha economics, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Polyethylene Glycols economics, Private Sector economics, Recombinant Proteins economics, Recombinant Proteins therapeutic use, Retrospective Studies, Ribavirin economics, Risk Assessment, Severity of Illness Index, Time Factors, Treatment Outcome, Alcohol Drinking adverse effects, Delivery of Health Care, Integrated economics, Hepatitis C drug therapy, Interferon-alpha therapeutic use, Polyethylene Glycols therapeutic use, Ribavirin therapeutic use
- Abstract
Unlabelled: Treatment of chronic hepatitis C infection (HCV(+) ) has historically been shown to be less effective in patients with a heavy drinking history. The effect of moderate and heavy alcohol use on treatment with pegylated interferon-alpha and ribavirin (P/R) in an insured household population has not been previously reported. We investigated the effect of alcohol on treatment outcome in a cohort of 421 treatment-naïve HCV(+) patients, members of an integrated health care plan treated with P/R between January 2002 and June 2008. A detailed drinking history was obtained for 259 (61.5%) eligible patients. Regular drinking was reported by 93.1% of patients before HCV diagnosis, by 30.9% between HCV diagnosis and treatment, by 1.9% during treatment, and 11.6% after the end of treatment. Heavy drinking patterns were reported by 67.9%, 63.5% of patients drank more than 100 kg of ethanol before initiating HCV treatment, and 29.3% reported abstaining less than the required 6 months before treatment. Despite these reports of heavy drinking, sustained virological responses (SVRs) were obtained in 80.2% of patients with HCV genotypes 2 or 3 and 45.1% of patients with genotypes 1, 4, or 6. Pretreatment drinking patterns and total alcohol intake were both unrelated to SVR rates. Abstaining less than 6 months before treatment was related to lower SVR rates in moderate, but not heavy, drinkers. HCV treatment relapse was unrelated to drinking after treatment ended., Conclusion: The amount of alcohol consumed before HCV treatment did not have a negative effect on treatment outcomes in our population. A history of heavy drinking should not be considered a deterrent to HCV treatment in members of an integrated health care plan who are closely monitored., (Copyright © 2012 American Association for the Study of Liver Diseases.)
- Published
- 2012
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