A recent study published online describes an association between former and current excessive alcohol use and higher rates of infection, morbidity and mortality in patients with the hepatitis C virus (HCV).

Amber L Taylor, MPH, of the Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention in Atlanta and colleagues analyzed data from 20,042 study participants from the 2003-2010 National Health and Nutrition Examination Survey (NHANES) in 2014 and estimated HCV rates among adults who use alcohol. They published their findings in The American Journal of Preventative Medicine.

Even when researchers accounted for age, race/ethnicity, education and health care availability, the highest rates of HCV were among former excessive drinkers (2.2%) and current excessive drinkers (1.5%). People who never drank were only 0.4% as likely to have HCV; non-excessive current drinkers were 0.9% as likely.


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Ms Taylor and colleagues estimated that people with HCV were 3.3 times more likely to drink 5 or more drinks per day at some point during their lifetimes than people without HCV (43.8% vs 13.7%, p<.001). Drinking alcohol speeds the progression of HCV-related complications such as cirrhosis and hepatocellular carcinoma. “In 2010, alcohol-related liver disease ranked third as a cause of death among people with hepatitis C,” the researchers wrote.

Ms. Taylor and colleagues reported that former excessive drinkers were much more likely to be non-Hispanic black, women and older. They were without a usual source of medical care, had a high school level or less for education and an income of less than twice the poverty level. Current excessive drinkers tended to be men, and younger. They also had a high school level of education or less, and no usual source of health care.

“Morbidity and mortality among people with chronic HCV infection is exacerbated by excessive alcohol use, which accelerates fibrosis,” the researchers noted. 

As a modifiable behavior, drinking needs to be addressed, particularly in younger men with HCV who may have limited access to health insurance and care, Ms Taylor and colleagues noted, adding that alcohol information for patients with HCV should be administered outside of health facilities as many patients do not have access due to lack of insurance.

Researchers noted evidence that pointed to brief counseling with follow-up and external support as an effective means of reducing  alcohol use among people with HCV infection. “Motivational Enhancement Therapy has been found to increase abstinence among chronic HCV patients who currently drink and suffer from alcohol use disorders,” researchers said. They added that people with HCV are often unaware of alcohol’s damaging effects due to their illness.

“Findings suggest that many excessive current drinkers did not have a usual source of medical care and or health insurance. Public health actions against alcohol abuse, therefore, should also be available outside of clinical settings and targeted to both those with and without HCV infection,” researchers concluded.

Reference

1. Taylor AL, Denniston MSPH, Klevens RM et al. Association of hepatitis C virus with alcohol use among US adults: NHANES 2003–2010. Am J Prev Med. Published Online May 10, 2016. Accessed May 31, 2016.