The impact of past alcohol use on treatment response rates in patients with chronic hepatitis C.
BACKGROUND
Studies have shown that past alcohol consumption reduces response rates in patients with chronic hepatitis C treated with interferon monotherapy.


OBJECTIVE
To clarify the importance of alcohol consumption on response rates in patients undergoing treatment with pegylated interferon and ribavirin.


METHODS
In a single centre, prospective study, median daily alcohol consumption (determined by previously validated method) and quartiles of alcohol consumption were calculated. Univariate and binary logistic regression analyses were performed using treatment response status as the dependent variable.


RESULTS
Overall, in an intention-to-treat analysis, 34 of 115 patients (30%) responded to treatment. In univariate analysis, black patients, especially those with hepatitis C virus genotype 1, high viral load and low alanine aminotransferase were significantly less likely to respond. Predictors of response by regression analysis included alcohol <30 g/day (OR=3.02, 95% CI: 1.02-8.93; P=0.04), non-genotype 1 status (OR=1.98, 95% CI: 1.03-3.80; P=0.04) and non-black race (OR=2.79, 95% CI: 1.33-5.85; P=0.006).


CONCLUSIONS
Median daily alcohol use >30 g/day is associated with failure to respond to pegylated interferon and ribavirin for treatment of hepatitis C. Past alcohol use should be evaluated when considering treatment for hepatitis C.
Chang
A
A
Department of Medicine, Temple University Hospital, Philadelphia, PA 19140, USA.
Skole
K
K
Gautam
M
M
Schmutz
J
J
Black
M
M
Thomas
R
R
Horwitz
B
B
Friedenberg
F K
FK
D000328:Adult; D000428:Alcohol Drinking; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D044383:Black People; D004359:Drug Therapy, Combination; D000431:Ethanol / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000208:ethnology / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011379:Prognosis; D011446:Prospective Studies; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*; D017211:Treatment Failure; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D000431:Ethanol; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b