The impact of lifetime alcohol use on hepatitis C treatment outcomes in privately insured members of an integrated health care plan.
The impact of lifetime alcohol use on hepatitis C treatment outcomes in privately insured members of an integrated health care plan.
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终身饮酒对综合医疗保健计划私人保险成员丙型肝炎治疗结果的影响。
DOI：
10.1002/hep.25755
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
Martin,Scott
中科院分区：
文献类型：
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作者：
Russell,Marcia;Pauly,MaryPatricia;Moore,CharlesDenton;Chia,Constance;Dorrell,Jennifer;Cunanan,ReneeJ;Witt,Gayle;Martin,Scott
历史证明，慢性丙型肝炎感染（HCV+）的治疗对于有大量饮酒史的患者效果较差。此前尚未报道过中度和重度饮酒对受保家庭人群接受聚乙二醇化干扰素-α和利巴韦林 (P/R) 治疗的影响。我们调查了酒精对治疗结果的影响，该队列由 421 名未接受治疗的 HCV+ 患者组成，他们是 2002 年 1 月至 2008 年 6 月期间接受 P/R 治疗的综合医疗保健计划的成员。获得了 259 名 (61.5%) 符合条件的患者的详细饮酒史。 93.1%的患者在HCV诊断前报告经常饮酒，在HCV诊断和治疗期间为30.9%，在治疗期间为1.9%，在治疗结束后为11.6%。 67.9% 的患者报告有大量饮酒模式，63.5% 的患者在开始 HCV 治疗前饮酒超过 100 公斤乙醇，29.3% 的患者报告在治疗前 6 个月戒酒量低于要求。尽管有这些大量饮酒的报告，80.2% 的 HCV 基因型 2 或 3 患者和 45.1% 的基因型 1、4 或 6 患者获得了持续病毒学应答 (SVR)。治疗前饮酒模式和总酒精摄入量均与 SVR 率无关。中度饮酒者（而非重度饮酒者）治疗前戒酒时间少于 6 个月与较低的 SVR 率相关。 HCV 治疗复发与治疗结束后饮酒无关。结论：HCV 治疗前饮酒量对我们人群的治疗结果没有负面影响。对于接受密切监测的综合医疗保健计划成员来说，酗酒史不应被视为阻碍 HCV 治疗。 （肝病学2012）
Treatment of chronic hepatitis C infection (HCV+) has historically been shown to be less effective in patients with a heavy drinking history. The effect of moderate and heavy alcohol use on treatment with pegylated interferon‐alpha and ribavirin (P/R) in an insured household population has not been previously reported. We investigated the effect of alcohol on treatment outcome in a cohort of 421 treatment‐naïve HCV+patients, members of an integrated health care plan treated with P/R between January 2002 and June 2008. A detailed drinking history was obtained for 259 (61.5%) eligible patients. Regular drinking was reported by 93.1% of patients before HCV diagnosis, by 30.9% between HCV diagnosis and treatment, by 1.9% during treatment, and 11.6% after the end of treatment. Heavy drinking patterns were reported by 67.9%, 63.5% of patients drank more than 100 kg of ethanol before initiating HCV treatment, and 29.3% reported abstaining less than the required 6 months before treatment. Despite these reports of heavy drinking, sustained virological responses (SVRs) were obtained in 80.2% of patients with HCV genotypes 2 or 3 and 45.1% of patients with genotypes 1, 4, or 6. Pretreatment drinking patterns and total alcohol intake were both unrelated to SVR rates. Abstaining less than 6 months before treatment was related to lower SVR rates in moderate, but not heavy, drinkers. HCV treatment relapse was unrelated to drinking after treatment ended.Conclusion:The amount of alcohol consumed before HCV treatment did not have a negative effect on treatment outcomes in our population. A history of heavy drinking should not be considered a deterrent to HCV treatment in members of an integrated health care plan who are closely monitored. (HEPATOLOGY2012)