TY - JOUR
T1 - Unreported alcohol use was common but did not impact hepatitis C cure in HIV-infected persons who use drugs
AU - Irvin, Risha
AU - Chander, Geetanjali
AU - Ward, Kathleen M.
AU - Manogue, Sean
AU - Falade-Nwulia, Oluwaseun
AU - Moon, Juhi
AU - Sutcliffe, Catherine G.
AU - Brinkley, Sherilyn
AU - Haselhuhn, Taryn
AU - Katz, Stephanie
AU - Herne, Kayla
AU - Arteaga, Lilian
AU - Thomas, David L.
AU - Mehta, Shruti H.
AU - Sulkowski, Mark S.
N1 - Funding Information:
The authors would like to thank the participants and study staff of the CHAMPS (Chronic HepAtitis C Management to ImProve OutcomeS) study. This work was supported by the National Institutes of Health (grant numbers R01DA16065, R37DA013806, U01DA036935, K24DA034621, K23DA041294, K24AA027483 and U24AA020801). This work was also made possible by the Johns Hopkins Institute for Clinical and Translational Research and the Center for Clinical Data Analytics (funded in part by grant number UL1 TR001079) and the Johns Hopkins Center for AIDS Research (grant number P30AI094189). Study medication was provided by Gilead Sciences (Foster City, CA).
Funding Information:
The authors would like to thank the participants and study staff of the CHAMPS (Chronic HepAtitis C Management to ImProve OutcomeS) study. This work was supported by the National Institutes of Health (grant numbers R01DA16065, R37DA013806, U01DA036935, K24DA034621, K23DA041294, K24AA027483 and U24AA020801). This work was also made possible by the Johns Hopkins Institute for Clinical and Translational Research and the Center for Clinical Data Analytics (funded in part by grant number UL1 TR001079) and the Johns Hopkins Center for AIDS Research (grant number P30AI094189). Study medication was provided by Gilead Sciences (Foster City, CA).
Publisher Copyright:
© 2019 John Wiley & Sons Ltd
PY - 2020/5/1
Y1 - 2020/5/1
N2 - We investigated the prevalence and impact of heavy alcohol use on the hepatitis C virus (HCV) care continuum amongst HIV/HCV co-infected persons who use drugs. In the CHAMPS study, 144 HIV/HCV co-infected persons were randomized to contingent cash incentives, peer mentors and usual care to evaluate the impact on HCV care. Alcohol use was ascertained using the 10-item AUDIT (hazardous: male ≥8, female ≥4) and phosphatidylethanol (PEth) (heavy: ≥50 ng/mL), an alcohol biomarker. Log binomial regression was used to evaluate the association between heavy alcohol use and failure to initiate treatment and to achieve sustained virologic response (SVR). Of the 135 participants with PEth data, median age was 55 years, 59% were male, 92% were Black, 91% reported a history of drug use, and 97% were on antiretroviral therapy. Hazardous drinking was reported on AUDIT by 28% of participants, and 35% had heavy alcohol use by PEth. Of the 47 individuals with a PEth ≥50 ng/mL, 23 (49%) reported no or minimal alcohol use by AUDIT. HCV treatment was initiated in 103 of 135 participants, and SVR was achieved in 92%. PEth ≥50 ng/mL (Relative Risk [RR] 0.72, 95% CI 0.35-1.48) was not significantly associated with failure to initiate HCV treatment or failure to achieve SVR (RR 0.85, 95% CI 0.46-1.57).In conclusion, alcohol use was common and frequently not detected by self-report. However, heavy alcohol use, even when measured objectively, was not associated with failure to initiate HCV treatment or to achieve cure.
AB - We investigated the prevalence and impact of heavy alcohol use on the hepatitis C virus (HCV) care continuum amongst HIV/HCV co-infected persons who use drugs. In the CHAMPS study, 144 HIV/HCV co-infected persons were randomized to contingent cash incentives, peer mentors and usual care to evaluate the impact on HCV care. Alcohol use was ascertained using the 10-item AUDIT (hazardous: male ≥8, female ≥4) and phosphatidylethanol (PEth) (heavy: ≥50 ng/mL), an alcohol biomarker. Log binomial regression was used to evaluate the association between heavy alcohol use and failure to initiate treatment and to achieve sustained virologic response (SVR). Of the 135 participants with PEth data, median age was 55 years, 59% were male, 92% were Black, 91% reported a history of drug use, and 97% were on antiretroviral therapy. Hazardous drinking was reported on AUDIT by 28% of participants, and 35% had heavy alcohol use by PEth. Of the 47 individuals with a PEth ≥50 ng/mL, 23 (49%) reported no or minimal alcohol use by AUDIT. HCV treatment was initiated in 103 of 135 participants, and SVR was achieved in 92%. PEth ≥50 ng/mL (Relative Risk [RR] 0.72, 95% CI 0.35-1.48) was not significantly associated with failure to initiate HCV treatment or failure to achieve SVR (RR 0.85, 95% CI 0.46-1.57).In conclusion, alcohol use was common and frequently not detected by self-report. However, heavy alcohol use, even when measured objectively, was not associated with failure to initiate HCV treatment or to achieve cure.
KW - HIV
KW - alcohol use
KW - hepatitis C care continuum
KW - hepatitis C virus
KW - substance use
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UR - http://www.scopus.com/inward/citedby.url?scp=85078617139&partnerID=8YFLogxK
U2 - 10.1111/jvh.13251
DO - 10.1111/jvh.13251
M3 - Article
C2 - 31854069
AN - SCOPUS:85078617139
SN - 1352-0504
VL - 27
SP - 476
EP - 483
JO - Journal of Viral Hepatitis
JF - Journal of Viral Hepatitis
IS - 5
ER -