The effects of alcohol on spontaneous clearance of acute hepatitis C virus infection in females versus males.
Approximately one quarter of persons exposed to hepatitis C virus (HCV) will spontaneously clear infection. We undertook this study to investigate the impact of alcohol on likelihood of HCV spontaneous viral clearance stratified by sex groups.



Pooled data from an international collaboration of prospective observational studies of incident HIV and HCV infection in high-risk cohorts (the InC3 Study) was restricted to 411 persons (or 560.7 person-years of observation) with documented acute HCV infection and data regarding alcohol use. The predictor of interest was self-reported alcohol use at or after estimated date of incident HCV infection and the outcome was HCV spontaneous clearance. Sex stratified Cox proportional hazards models were used to evaluate the association between alcohol and spontaneous clearance, adjusting for age, race/ethnicity, and IFNL4 genotype.



The median age was 28.5 years, 30.4% were women, 87.2% were white, and 71.8% reported alcohol use at or after incident infection. There were 89 (21.6%) cases of spontaneous clearance observed, 39 (31.2%) among women and 50 (17.5%) in men (p<0.01). Overall, spontaneous clearance occurred less frequently among participants who drank alcohol compared to those who did not drink (18.9% v. 28.5%, p=0.03). After adjustment for other covariates, alcohol was significantly and independently associated with lower relative hazards for spontaneous clearance of HCV in women (AHR=0.35; 95% CI: 0.19-0.66; p=0.001) but not in men (AHR=0.63; 95% CI: 0.36-1.09; p=0.10).



Results indicate that abstaining from drinking alcohol may increase the likelihood of spontaneous clearance among women.
Division of General Internal Medicine, Department of Medicine, University of Washington, 325 9th Avenue Seattle, WA 98104, USA. Electronic address: tsuij@uw.edu.
Judith I
JI
Tsui
Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, Second Floor, San Francisco, CA 94158, USA.
Ali
A
Mirzazadeh
Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, Second Floor, San Francisco, CA 94158, USA; Department of Medicine, University of California, San Francisco, 3333 California Street, Suite 430, San Francisco, CA 94118, USA.
Judith A
JA
Hahn
The Kirby Institute, University of New South Wales, Wallace Wurth Building, UNSW Australia, Sydney NSW 2052, Australia.
Lisa
L
Maher
Centre de Recherche du CHUM, Université de Montréal, 900 Rue Saint-Denis, Montréal, QC H2X0A9, Canada.
Julie
J
Bruneau
The Kirby Institute, University of New South Wales, Wallace Wurth Building, UNSW Australia, Sydney NSW 2052, Australia.
Jason
J
Grebely
Burnet Institute, 85 Commercial Rd., Melbourne VIC 3004, Australia.
Margaret
M
Hellard
Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA.
Arthur Y
AY
Kim
Centre de Recherche du CHUM, Université de Montréal, 900 Rue Saint-Denis, Montréal, QC H2X0A9, Canada.
Naglaa H
NH
Shoukry
Department of Medicine, Johns Hopkins Medical Institutions, 1830 E. Monument Street, Baltimore, MD 21287, USA.
Andrea L
AL
Cox
Cluster Infectious Diseases, GGD Public Health Service of Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, Postbus 2200, 1000 CE Amsterdam, The Netherlands.
Maria
M
Prins
The Kirby Institute, University of New South Wales, Wallace Wurth Building, UNSW Australia, Sydney NSW 2052, Australia.
Gregory J
GJ
Dore
Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA.
Georg
G
Lauer
University of New South Wales, School of Medical Sciences, Wallace Wurth Building, UNSW Australia, Sydney NSW 2052, Australia.
Andrew R
AR
Lloyd
Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM 87131, USA.
Kimberly
K
Page
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D016174:Hepacivirus / Q000378:metabolism*; D006526:Hepatitis C / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012727:Sex Characteristics; D055815:Young Adult
Blood-borne viral infections; Ethanol; Hepatitis C virus; Injection drug use; Sexual dimorphism; Substance use