Finasteride and methadone use and risk of advanced hepatitis C related liver disease.
OBJECTIVE
We evaluated the association between two medications that alter bioavailable androgen levels, finasteride and methadone, and risk of advanced HCV-related liver disease.


BACKGROUND
Males have strikingly greater cirrhosis risk across disease etiologies, including hepatitis C virus (HCV) infection.


METHODS
In a cross-sectional study in HCV+ male veterans, we determined medication use by up to 15-year medical record review, and hepatic pathology by the FibroSURE-ActiTest (F3/F4-F4, advanced vs. F0-F3, mild fibrosis; and A2/A3-A3, advanced vs. A0-A2, mild inflammation). We performed race-adjusted and race-stratified multivariate analyses.


RESULTS
Among 571 HCV+ males, 43 % were White and 57 % African-American. There were non-significant decreased risks with finasteride use (OR(adj advanced fibrosis) = 0.75, 95 % CI 0.39-1.45 and OR(adj advanced inflammation) = 0.74, 95 % CI 0.41-1.43). For methadone, there was a non-significant 41 % increased advanced fibrosis risk in Whites and 51 % reduced risk in AA. White male methadone-users had 2.1-fold excess advanced inflammation risk (p = 0.15).


CONCLUSIONS
Our preliminary study results suggest finasteride use is not significantly associated with a decreased risk of advanced hepatic fibrosis or inflammation in HCV+ males. The ethnically-divergent results for methadone associated fibrosis risk and finding of potentially increased inflammation risk in White males suggests the need for additional research.
Clinical Epidemiology and Outcomes Program, Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey Veteran Affairs Medical Center, Houston, TX, USA. dwhite1@bcm.edu
Donna L
DL
White
Ali
A
Hashmi
David J
DJ
Ramsey
Jill
J
Kuzniarek
Shahriar
S
Tavakoli-Tabasi
Hashem B
HB
El-Serag
D058891:5-alpha Reductase Inhibitors / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D018120:Finasteride / Q000008:administration & dosage*; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology* / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage*; D018570:Risk Assessment; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D014728:Veterans
D058891:5-alpha Reductase Inhibitors; D009294:Narcotics; D018120:Finasteride; D008691:Methadone