title: Management of hepatitis C virus infection in heavy drinkers.
abstract: OBJECTIVE
  Optimal management of hepatitis C virus (HCV) infection is controversial in heavy drinkers. We compared the management of HCV infection of heavy drinkers with that of patients without a history of alcohol abuse.
  
  
  METHODS
  In a retrospective case-control study, 69 HCV-infected heavy drinkers [daily alcohol consumption at referral above 60 g/day, hereafter 'alcohol group'] were compared with matched HCV-infected patients with low alcohol consumption (<40 g/day, 'control group').
  
  
  RESULTS
  Patients of the 'alcohol group' were younger (42 vs. 45 years, P = 0.05), more often male (69.6 vs. 56.5%, P = 0.11) and had been infected by intravenous drug use (85.5 vs. 45.0%, P < 0.0001). The percentage of patients with a recommendation for treatment according to the French 2002 consensus (bridging fibrosis or genotype 2 or 3) was 52 of 69 (75.4%) in both groups, while the proportion of patients treated was higher in the control group (71.0 vs. 44.9%, P = 0.002). In the 'alcohol group', patients had better access to treatment if they were employed or consumed 170 g/day or less at first referral. Sustained virological response (SVR) was obtained in 10 of 31 patients (32.3%) of the 'alcohol group' vs. 8 of 31 patients (25.8%) of the control group matched for genotype and type of treatment (P = 0.58).
  
  
  CONCLUSIONS
  Heavy drinkers are less often considered for antiviral therapy compared with patients without a history of alcohol abuse. However, once treatment is actually initiated, SVR rates are comparable with those achieved in non-drinkers despite the continuation of alcohol consumption during therapy in some patients.
authors.affiliation: Unité d’Hépatologie et d’Addictologie, Hôpital Cochin, Assistance Publique des Hôpitaux de Paris, 27 rue du faubourg Saint Jacques, 75014 Paris, France.
authors.forename: Charlotte E
authors.initials: CE
authors.lastname: Costentin
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Trabut
authors.forename: Vincent
authors.initials: V
authors.lastname: Mallet
authors.forename: Stéphane
authors.initials: S
authors.lastname: Darbeda
authors.forename: Véronique
authors.initials: V
authors.lastname: Thépot
authors.forename: Bertrand
authors.initials: B
authors.lastname: Nalpas
authors.forename: Béatrice
authors.initials: B
authors.lastname: Badin de Montjoye
authors.forename: Béatrice
authors.initials: B
authors.lastname: Lavielle
authors.forename: Anaïs
authors.initials: A
authors.lastname: Vallet-Pichard
authors.forename: Philippe
authors.initials: P
authors.lastname: Sogni
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000523:psychology; D000437:Alcoholism / Q000150:complications*; D000998:Antiviral Agents / Q000627:therapeutic use; D019090:Case Management; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D003627:Data Interpretation, Statistical; D005260:Female; D005838:Genotype; D006297:Health Services Accessibility; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D013695:Temperance; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens