Paul J. Clark, Patricia C. Valery, Simone I. Strasser, Martin Weltman, Alex Thompson, Miriam T. Levy, Barbara Leggett, Amany Zekry, Julian Rong, Marie Sinclair, Jacob George, William Sievert, Gerry MacQuillan, Edmund Tse, Amanda Nicoll, Amanda Wade, Wendy Cheng, Stuart K. Roberts
{"title":"酒精不会影响慢性丙型肝炎的治疗效果，但会增加进展性肝病的风险：澳大利亚前瞻性多中心研究（OPERA-C）的结果。","authors":"Paul J. Clark, Patricia C. Valery, Simone I. Strasser, Martin Weltman, Alex Thompson, Miriam T. Levy, Barbara Leggett, Amany Zekry, Julian Rong, Marie Sinclair, Jacob George, William Sievert, Gerry MacQuillan, Edmund Tse, Amanda Nicoll, Amanda Wade, Wendy Cheng, Stuart K. Roberts","doi":"10.1111/dar.13914","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Alcohol use is common in patients with chronic hepatitis C virus (HCV) infection. We examined the impact of alcohol use on direct-acting antiviral (DAA) therapy outcome and the clinical course of liver disease and 2-year survival for patients receiving HCV DAA therapy.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Adults (<i>n</i> = 2624) recruited from 26 Australian hospital liver clinics during 2016–2021 were followed up for 2 years. Risky alcohol use was defined by a combination of self-report (≥40 g/day of ethanol), physician-reported history of problematic alcohol use, and anti-craving medication prescription via population-based database linkage. We examined factors associated with advanced liver fibrosis and survival using multivariable logistic and Cox regression.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Among 1634 patients (62.3%) with risky alcohol use, 24.6% reported consuming ≥40 g/day of alcohol, 98.3% physician-reported problematic alcohol use; only 4.1% were dispensed naltrexone/acamprosate. One hundred and forty-three patients with cirrhosis reported ≥40 g/day of alcohol, 6 (4.3%) were prescribed naltrexone/acamprosate. Risky alcohol use was associated with advanced fibrosis (adjusted-odds ratio 1.69, 95% confidence interval 1.32–2.17) and patients were over-represented for cirrhosis (45.1% vs. 25.6% in no-risky alcohol use [<i>p</i> < 0.001]) and hepatocellular carcinoma (5.7% vs. 2.5% [<i>p</i> < 0.001]). Sustained viral response (<i>p</i> = 0.319) and 2-year survival (adjusted-hazard ratio 1.98, 95% confidence interval 0.84–4.63) after DAA therapy were not associated with risky alcohol use.</p>\n </section>\n \n <section>\n \n <h3> Discussion and Conclusions</h3>\n \n <p>Risky alcohol use in HCV patients was prevalent, but did not reduce HCV cure. Treatment for alcohol dependence was low. Risky alcohol use may be under-recognised in liver clinics. Better integration of addiction medicine into liver services and increased resourcing and addiction medicine training opportunities for hepatologists may help address this.</p>\n </section>\n </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 6","pages":"1559-1572"},"PeriodicalIF":3.0000,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.13914","citationCount":"0","resultStr":"{\"title\":\"Alcohol does not impact chronic hepatitis C treatment outcomes but increases risk for progressive liver disease: Findings from a prospective multicentre Australian study (OPERA-C)\",\"authors\":\"Paul J. Clark, Patricia C. Valery, Simone I. Strasser, Martin Weltman, Alex Thompson, Miriam T. Levy, Barbara Leggett, Amany Zekry, Julian Rong, Marie Sinclair, Jacob George, William Sievert, Gerry MacQuillan, Edmund Tse, Amanda Nicoll, Amanda Wade, Wendy Cheng, Stuart K. Roberts\",\"doi\":\"10.1111/dar.13914\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Alcohol use is common in patients with chronic hepatitis C virus (HCV) infection. We examined the impact of alcohol use on direct-acting antiviral (DAA) therapy outcome and the clinical course of liver disease and 2-year survival for patients receiving HCV DAA therapy.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Adults (<i>n</i> = 2624) recruited from 26 Australian hospital liver clinics during 2016–2021 were followed up for 2 years. Risky alcohol use was defined by a combination of self-report (≥40 g/day of ethanol), physician-reported history of problematic alcohol use, and anti-craving medication prescription via population-based database linkage. We examined factors associated with advanced liver fibrosis and survival using multivariable logistic and Cox regression.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Among 1634 patients (62.3%) with risky alcohol use, 24.6% reported consuming ≥40 g/day of alcohol, 98.3% physician-reported problematic alcohol use; only 4.1% were dispensed naltrexone/acamprosate. One hundred and forty-three patients with cirrhosis reported ≥40 g/day of alcohol, 6 (4.3%) were prescribed naltrexone/acamprosate. Risky alcohol use was associated with advanced fibrosis (adjusted-odds ratio 1.69, 95% confidence interval 1.32–2.17) and patients were over-represented for cirrhosis (45.1% vs. 25.6% in no-risky alcohol use [<i>p</i> < 0.001]) and hepatocellular carcinoma (5.7% vs. 2.5% [<i>p</i> < 0.001]). Sustained viral response (<i>p</i> = 0.319) and 2-year survival (adjusted-hazard ratio 1.98, 95% confidence interval 0.84–4.63) after DAA therapy were not associated with risky alcohol use.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Discussion and Conclusions</h3>\\n \\n <p>Risky alcohol use in HCV patients was prevalent, but did not reduce HCV cure. Treatment for alcohol dependence was low. Risky alcohol use may be under-recognised in liver clinics. Better integration of addiction medicine into liver services and increased resourcing and addiction medicine training opportunities for hepatologists may help address this.</p>\\n </section>\\n </div>\",\"PeriodicalId\":11318,\"journal\":{\"name\":\"Drug and alcohol review\",\"volume\":\"43 6\",\"pages\":\"1559-1572\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-08-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.13914\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Drug and alcohol review\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/dar.13914\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SUBSTANCE ABUSE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drug and alcohol review","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/dar.13914","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SUBSTANCE ABUSE","Score":null,"Total":0}
Alcohol does not impact chronic hepatitis C treatment outcomes but increases risk for progressive liver disease: Findings from a prospective multicentre Australian study (OPERA-C)
Introduction
Alcohol use is common in patients with chronic hepatitis C virus (HCV) infection. We examined the impact of alcohol use on direct-acting antiviral (DAA) therapy outcome and the clinical course of liver disease and 2-year survival for patients receiving HCV DAA therapy.
Methods
Adults (n = 2624) recruited from 26 Australian hospital liver clinics during 2016–2021 were followed up for 2 years. Risky alcohol use was defined by a combination of self-report (≥40 g/day of ethanol), physician-reported history of problematic alcohol use, and anti-craving medication prescription via population-based database linkage. We examined factors associated with advanced liver fibrosis and survival using multivariable logistic and Cox regression.
Results
Among 1634 patients (62.3%) with risky alcohol use, 24.6% reported consuming ≥40 g/day of alcohol, 98.3% physician-reported problematic alcohol use; only 4.1% were dispensed naltrexone/acamprosate. One hundred and forty-three patients with cirrhosis reported ≥40 g/day of alcohol, 6 (4.3%) were prescribed naltrexone/acamprosate. Risky alcohol use was associated with advanced fibrosis (adjusted-odds ratio 1.69, 95% confidence interval 1.32–2.17) and patients were over-represented for cirrhosis (45.1% vs. 25.6% in no-risky alcohol use [p < 0.001]) and hepatocellular carcinoma (5.7% vs. 2.5% [p < 0.001]). Sustained viral response (p = 0.319) and 2-year survival (adjusted-hazard ratio 1.98, 95% confidence interval 0.84–4.63) after DAA therapy were not associated with risky alcohol use.
Discussion and Conclusions
Risky alcohol use in HCV patients was prevalent, but did not reduce HCV cure. Treatment for alcohol dependence was low. Risky alcohol use may be under-recognised in liver clinics. Better integration of addiction medicine into liver services and increased resourcing and addiction medicine training opportunities for hepatologists may help address this.
期刊介绍：
Drug and Alcohol Review is an international meeting ground for the views, expertise and experience of all those involved in studying alcohol, tobacco and drug problems. Contributors to the Journal examine and report on alcohol and drug use from a wide range of clinical, biomedical, epidemiological, psychological and sociological perspectives. Drug and Alcohol Review particularly encourages the submission of papers which have a harm reduction perspective. However, all philosophies will find a place in the Journal: the principal criterion for publication of papers is their quality.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
