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Alcohol use and hepatitis C virus treatment outcomes among patients receiving direct antiviral agents

Tsui, Judith I. ; Williams, Emily C. ; Green, Pamela K. ; Berry, Kristin ; Su, Feng ; Ioannou, George N.

Drug and alcohol dependence, 2016-12, Vol.169, p.101-109 [Periódico revisado por pares]

Ireland: Elsevier B.V

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Título:
Alcohol use and hepatitis C virus treatment outcomes among patients receiving direct antiviral agents
Autor: Tsui, Judith I. ; Williams, Emily C. ; Green, Pamela K. ; Berry, Kristin ; Su, Feng ; Ioannou, George N.
Assuntos: Aged ; Alcohol Drinking - drug therapy ; Alcohol Drinking - epidemiology ; Alcohol related disorders ; Alcohol use ; Alcoholic beverages ; Alcoholism ; Alcoholism - drug therapy ; Alcoholism - epidemiology ; Antiviral agents ; Antiviral Agents - pharmacology ; Antiviral Agents - therapeutic use ; Antiviral drugs ; AUDIT-C ; Categories ; Clinical outcomes ; Clinical practice guidelines ; Direct antiviral agents ; Disorders ; Drinking ; Drinking behavior ; Drug Therapy, Combination ; Female ; Health care ; Hepacivirus - drug effects ; Hepatitis ; Hepatitis C ; Hepatitis C - drug therapy ; Hepatitis C - epidemiology ; Hepatitis c treatment ; Humans ; Identification methods ; Imputing ; Male ; Medical screening ; Men ; Middle Aged ; Patients ; Questionnaires ; Regression analysis ; Ritonavir ; Sofosbuvir - pharmacology ; Sofosbuvir - therapeutic use ; Substance use disorder ; Surveys and Questionnaires ; Sustained Virologic Response ; Treatment Outcome ; Veterans ; Viruses
É parte de: Drug and alcohol dependence, 2016-12, Vol.169, p.101-109
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Undefined-1
ObjectType-Feature-3
content type line 23
Judith Tsui: Study concept and design, interpretation of data, drafting of the manuscript, critical revision of the manuscript.
Kristin Berry: Statistical analysis and interpretation of data, critical revision of the manuscript.
Contributors
Feng Su: Interpretation of data, critical revision of the manuscript.
George Ioannou is the guarantor of this paper.
Emily Williams: Study design, interpretation of data, critical revision of the manuscript.
George Ioannou: Acquisition of data, statistical analysis and interpretation of data, critical revision of the manuscript, obtained funding.
Pamela Green: Statistical analysis and interpretation of data, critical revision of the manuscript.
Descrição: •31.5% of patients on hepatitis C virus (HCV) treatment reported alcohol use in the previous year.•Direct anti-viral agents (DAAs) resulted in high sustained virologic response (SVR) (“cure”) rates (>90%) regardless of alcohol use.•Unhealthy drinkers were slightly less likely to achieve SVR.•Alcohol users should not be excluded from HCV treatments. It is unclear whether alcohol use negatively impacts HCV treatment outcomes in the era of direct antiviral agents (DAAs). We aimed to evaluate the associations between current levels of drinking and treatment response among persons treated for HCV with DAAs in the national Veterans Affairs (VA) healthcare system. We identified patients who initiated HCV DAAs over 18 months (1/1/14–6/30/15) and had documented alcohol screening with the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) questionnaire within one year prior to initiating therapy. DAAs included: sofosbuvir (SOF), ledipasvir/sofosbuvir (LDV/SOF) or ombitasvir-paritaprevir-ritonavir, and dasabuvir (PrOD). AUDIT-C scores were categorized as 0 (abstinence), 1–3 (low-level drinking) and 4–12 (unhealthy drinking) in men or 0, 1–2 and 3–12 in women. Among 17,487 patients who initiated DAAs, 15,151 (87%) completed AUDIT-C screening: 10,387 (68.5%) were categorized as abstinent, 3422 (22.6%) as low-level drinking and 1342 (8.9%) as unhealthy drinking. There were no significant differences in sustained virologic response (SVR) rates between abstinent (SVR 91%; 95% CI: 91–92%), low-level drinking (SVR 93%; 95% CI 92–94%) or unhealthy drinking (SVR 91%; 95% 89–92) categories in univariable analysis or in multivariable logistic regression models. However, after imputing missing SVR data, unhealthy drinkers were less likely to achieve SVR in multivariable analysis (AOR 0.75, 95% CI 0.60-0.92). Absolute SVR rates were uniformly high among all persons regardless of alcohol use, with only minor differences in those who report unhealthy drinking, which supports clinical guidelines that do not recommend excluding persons with alcohol use.
Editor: Ireland: Elsevier B.V
Idioma: Inglês

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Alcohol use and hepatitis C virus treatment outcomes among patients receiving direct antiviral agents

Tsui, Judith I. ; Williams, Emily C. ; Green, Pamela K. ; Berry, Kristin ; Su, Feng ; Ioannou, George N.

Ireland: Elsevier B.V

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