Alcohol dependence presents a significant barrier to hepatitis C treatment among patients with HIV compared with non-alcohol substance dependence, according to a presentation at the International Symposium on Hepatitis Care in Substance Users.
According to the presentation by Kyle W. Prochno, a research coordinator from the Icahn School of Medicine at Mount Sinai, New York, alcohol-specific dependence was particularly prohibitive to HCV treatment initiation among patients with HIV, even when applying a treatment initiation-promoting intervention.
The study comprised 53 patients with HCV/HIV coinfection who had not engaged in HCV treatment within 12 months. Mean patient age was 53.9 years, 71.7% were men, 49.1% were Hispanic and 41.5% were black. Overall, 81.1% received a diagnosis of lifetime substance dependence, including cocaine (69.8%), alcohol (47.2%) and opioids (47.2%).
Researchers randomly assigned 28 patients to receive active intervention targeting psychosocial barriers to HCV treatment. They placed the remaining 25 patients in an “attention control” group with HIV education.
Patients with alcohol dependence were significantly less likely to initiate HCV treatment than those without alcohol dependence (24% vs. 53.6%; P = .028), whereas the researchers observed no association between treatment initiation and those with non-alcohol substance dependence.
After multivariable adjustment, patients with alcohol dependence were 0.13 times as likely to initiate treatment as those without after controlling for intervention technique (95% CI, 0.03-0.71).
By Talitha Bennett
Reference: Prochno KW. The impact of alcohol dependence on HCV treatment initiation in HIV/HCV co-infected patients. Presented at: International Symposium on Hepatitis Care in Substance Users; Sept. 6-8, 2017; New York.