Influence of Alcohol and Drug Consumption on Hepatitis C Treatment with Direct-Acting Antivirals
Author(s): Jose Carlos Fernandez de Canete Camacho*, Jose Maria Moreno Planas and Natalia Garcia Sanchez
Background: People who inject drugs (PWID) and harmful alcohol drinkers have been traditionally excluded from Hepatitis C Virus (HCV) treatment because of a reduced effectiveness. With the appearance of direct-acting antivirals (DAA) the effectiveness could be similar.
Objective: we evaluated the influence of harmful alcohol and drugs consumption on the effectiveness of the HCV treatment with DAA. Methods: 1792 patients were treated with DAA in 12 hospitals of the Spanish region of Castilla-La Mancha between 2004 and 2019. They were catalogued depending on their alcohol consumption (>30 g/ day and > 80 g/day), and antecedents of parenteral drug use, and the effectiveness of the treatment was evaluated according to the viral load 12 weeks after the end of treatment with the parameter “sustained viral response” (SVR12).
Results: 23.1% were consumers of >30g/day, 16.1% > 80 g/day, and 21.4% PWID. The global SVR12 rate was 91.5%. SVR12 was 85.2% in consumers of >30/day (p=0.20), 84.7% in > 80 g/day (p=0.24) and 84% in PWID (p=<0.01). When excluded the patients lost to follow-up from the analyses (10.1-10.2% in alcohol consumers; 12.5% PWID), SVR12 rate was similar in alcohol consumers (p=0.26), although in PWID rose to 96.5% (p=0.52).
Conclusions: the effectiveness with DAA treatment in HCV is similar in patients with and without alcohol consumption. In PWID the effectiveness is similar patients with an appropriate follow-up.