Impact of alcohol on the progression of HCV-related liver disease: A systematic review and meta-analysis

Llamosas-Falcón, Laura; Shield, Kevin D.; Gelovany, Maya; Hasan, Omer Syed Muhammad; Manthey, Jakob; Monteiro, Maristela; Walsh, Nick; Rehm, Jürgen

doi:10.1016/j.jhep.2021.04.018

Cited by 18 publications

(10 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, the higher risk for the same amount of alcohol can be explained by environmental variables, or interactions with other risk factors, such as crowding. Shield and Rehm [55] provide the list of diseases where various environmental factors play a large role: infectious diseases in general (i.e., all sexually transmitted diseases, including HIV/AIDS, pneumonia) but also liver cirrhosis (via the interaction with hepatitis B and C [59]), and road injuries show the biggest differences in standardized mortality after consuming one litre of pure ethanol.…”

Section: Modifiers Of Dose-response Relationshipsmentioning

confidence: 99%

Dose–Response Relationships between Levels of Alcohol Use and Risks of Mortality or Disease, for All People, by Age, Sex, and Specific Risk Factors

et al. 2021

Self Cite

View full text Add to dashboard Cite

Alcohol use has been causally linked to more than 200 disease and injury conditions, as defined by three-digit ICD-10 codes. The understanding of how alcohol use is related to these conditions is essential to public health and policy research. Accordingly, this study presents a narrative review of different dose–response relationships for alcohol use. Relative-risk (RR) functions were obtained from various comparative risk assessments. Two main dimensions of alcohol consumption are used to assess disease and injury risk: (1) volume of consumption, and (2) patterns of drinking, operationalized via frequency of heavy drinking occasions. Lifetime abstention was used as the reference group. Most dose–response relationships between alcohol and outcomes are monotonic, but for diabetes type 2 and ischemic diseases, there are indications of a curvilinear relationship, where light to moderate drinking is associated with lower risk compared with not drinking (i.e., RR < 1). In general, women experience a greater increase in RR per gram of alcohol consumed than men. The RR per gram of alcohol consumed was lower for people of older ages. RRs indicated that alcohol use may interact synergistically with other risk factors, in particular with socioeconomic status and other behavioural risk factors, such as smoking, obesity, or physical inactivity. The literature on the impact of genetic constitution on dose–response curves is underdeveloped, but certain genetic variants are linked to an increased RR per gram of alcohol consumed for some diseases. When developing alcohol policy measures, including low-risk drinking guidelines, dose–response relationships must be taken into consideration.

show abstract

Section: Modifiers Of Dose-response Relationshipsmentioning

confidence: 99%

Dose–Response Relationships between Levels of Alcohol Use and Risks of Mortality or Disease, for All People, by Age, Sex, and Specific Risk Factors

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…In C. [39][40][41] The VA does offer substance use disorder treatment, and any veteran can be referred and assessed for treatment, which may include inpatient, intensive outpatient, university model, or residential treatment programs. Some VA facilities partnered with residential substance use disorder program to integrate HCV treatment.…”

Section: Discussionmentioning

confidence: 99%

Alcohol Use and Sustained Virologic Response to Hepatitis C Virus Direct-Acting Antiviral Therapy

Cartwright,

Pierret,

Minassian

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceSome payers and clinicians require alcohol abstinence to receive direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection.ObjectiveTo evaluate whether alcohol use at DAA treatment initiation is associated with decreased likelihood of sustained virologic response (SVR).Design, Setting, and ParticipantsThis retrospective cohort study used electronic health records from the US Department of Veterans Affairs (VA), the largest integrated national health care system that provides unrestricted access to HCV treatment. Participants included all patients born between 1945 and 1965 who were dispensed DAA therapy between January 1, 2014, and June 30, 2018. Data analysis was completed in November 2020 with updated sensitivity analyses performed in 2023.ExposureAlcohol use categories were generated using responses to the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) questionnaire and International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnoses for alcohol use disorder (AUD): abstinent without history of AUD, abstinent with history of AUD, lower-risk consumption, moderate-risk consumption, and high-risk consumption or AUD.Main Outcomes and MeasuresThe primary outcome was SVR, which was defined as undetectable HCV RNA for 12 weeks or longer after completion of DAA therapy. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% CIs of SVR associated with alcohol category.ResultsAmong 69 229 patients who initiated DAA therapy (mean [SD] age, 62.6 [4.5] years; 67 150 men [97.0%]; 34 655 non-Hispanic White individuals [50.1%]; 28 094 non-Hispanic Black individuals [40.6%]; 58 477 individuals [84.5%] with HCV genotype 1), 65 355 (94.4%) achieved SVR. A total of 32 290 individuals (46.6%) were abstinent without AUD, 9192 (13.3%) were abstinent with AUD, 13 415 (19.4%) had lower-risk consumption, 3117 (4.5%) had moderate-risk consumption, and 11 215 (16.2%) had high-risk consumption or AUD. After adjustment for potential confounding variables, there was no difference in SVR across alcohol use categories, even for patients with high-risk consumption or AUD (OR, 0.95; 95% CI, 0.85-1.07). There was no evidence of interaction by stage of hepatic fibrosis measured by fibrosis-4 score (P for interaction = .30).Conclusions and RelevanceIn this cohort study, alcohol use and AUD were not associated with lower odds of SVR. Restricting access to DAA therapy according to alcohol use creates an unnecessary barrier to patients and challenges HCV elimination goals.

show abstract

“…Per capita consumption of alcohol is utilized to estimate the volume of alcohol use among drinkers to avoid bias; however, no correction exists for the prevalence of HED. This study did not fully account for the interaction between alcohol use and other risk factors, such as smoking (increased risk of cancer [28]), hepatitis B and C (increased risk of liver cirrhosis [29]), and obesity (increased risk of liver cirrhosis [24,30]). Furthermore, the study did not account for the differential alcohol RRs by socio-economic status.…”

Section: Limitationsmentioning

confidence: 99%

The Global Impact of Alcohol Consumption on Premature Mortality and Health in 2016

et al. 2021

Self Cite

View full text Add to dashboard Cite

This study aimed to estimate the impact of alcohol use on mortality and health among people 69 years of age and younger in 2016. A comparative risk assessment approach was utilized, with population-attributable fractions being estimated by combining alcohol use data from the Global Information System on Alcohol and Health with corresponding relative risk estimates from meta-analyses. The mortality and health data were obtained from the Global Health Observatory. Among people 69 years of age and younger in 2016, 2.0 million deaths and 117.2 million Disability Adjusted Life Years (DALYs) lost were attributable to alcohol consumption, representing 7.1% and 5.5% of all deaths and DALYs lost in that year, respectively. The leading causes of the burden of alcohol-attributable deaths were cirrhosis of the liver (457,000 deaths), road injuries (338,000 deaths), and tuberculosis (190,000 deaths). The numbers of premature deaths per 100,000 people were highest in Eastern Europe (155.8 deaths per 100,000), Central Europe (52.3 deaths per 100,000 people), and Western sub-Saharan Africa (48.7 deaths per 100,000). A large portion of the burden of disease caused by alcohol among people 69 years of age and younger is preventable through the implementation of cost-effective alcohol policies such as increases in taxation.

show abstract

Impact of alcohol on the progression of HCV-related liver disease: A systematic review and meta-analysis

Cited by 18 publications

References 61 publications

Dose–Response Relationships between Levels of Alcohol Use and Risks of Mortality or Disease, for All People, by Age, Sex, and Specific Risk Factors

Dose–Response Relationships between Levels of Alcohol Use and Risks of Mortality or Disease, for All People, by Age, Sex, and Specific Risk Factors

Alcohol Use and Sustained Virologic Response to Hepatitis C Virus Direct-Acting Antiviral Therapy

The Global Impact of Alcohol Consumption on Premature Mortality and Health in 2016

Contact Info

Product

Resources

About