Hepatitis C Worsens Outcomes in Patients Who Abuse Alcohol

The interaction between alcohol abuse and hepatitis C virus (HCV) can compromise overall survival outcomes, according to a study published in Clinical Epidemiology.

Between 10% and 20% of individuals who consume alcohol excessively develop alcoholic liver disease, according to the researchers. The study noted that approximately 20% of patients with alcoholic hepatitis have HCV. Notably, rates of liver-related mortality grew worldwide from 2005 to 2015, which reflects changes in risk factors such as excessive alcohol consumption and HCV infection, according to the study.

HCV infection is a significant risk factor for liver disease progression and related deaths due to conditions such as cirrhosis and hepatocellular cancer. Furthermore, individuals with HCV are more likely to consume alcohol than those without the virus, which may point to a link between poor outcomes and mortality from liver-related conditions, according to the study.

To evaluate the association, the researchers conducted a longitudinal study of 819 patients treated for alcohol abuse between 2000 and 2010. The authors collected data at entry into the study on alcohol use characteristics, alcoholic liver disease, and HCV infection.

Of the patients in the study, 15.8% were infected with HCV. There were 129 all-patient deaths over 5117 person-years during a median follow-up of 6.4 years, with 31 (24.6%) deaths among patients with HCV and 98 (15.4%) among HCV-negative patients.

The duration of survival among patients with HCV was 34% shorter than those who did not have the virus, while liver-related mortality was significantly higher among patients with HCV. Of the 129 patient deaths during the study, 48.4% were attributed to liver-related mortality, 22.4% were related to neoplasia, 11.6% were a result of nonnatural death, and 9.3% were due to cardiovascular disease.

The authors of the current study pointed to prior research that found up to 30% of patients with HCV may abuse alcohol. They also noted that liver-related mortality is 6-times greater in HCV-positive patients compared with HCV-negative patients with liver-related complications.

The current study’s limitations included a lack of data on changes in alcohol consumption over time and a lack of data on individuals with less severe patterns of alcohol consumption, which the authors said limited the generalization of results.

“Alcohol abuse/dependence and HCV infection are conditions that may have clinical consequences when interacting,” the authors concluded. “In summary, hepatitis C worsens the prognosis of liver disease and compromises the survival of alcohol-dependent patients. In this sense, treatment and care of HCV infection may result in better clinical outcomes in these patients.”