Many Unaware of HCV Status and the Dangers of Drink
A new study has tied former and current excessive alcohol drinking to a higher prevalence of chronic hepatitis C (HCV) infection. With an estimated 50% of those HCV-infected unaware of their infection, the link to alcohol has led researchers to call for greater testing and public health interventions.
In the study, published in the Journal of Preventative Medicine, researchers analyzed data from The National Health and Nutrition Examination Survey (NHANES) from between 2003–2010. Participants were classified into 1 of 4 groups for alcohol consumption, lifetime abstainers, former drinkers, non-excessive current drinkers, and excessive current drinkers; HCV status was also determined, with the specimens tested by the CDC's Division of Viral Hepatitis Laboratory.
In total 30,114 people were included in the analysis with 271 currently HCV-infected, 244 were able to provide sufficient information on alcohol consumption to be assessed. Results showed that those with chronic infections were 1.7 times more likely (31%, 95% CI=25.1, 37.6)) to be former drinkers than those who were never HCV-infected (17%, 95% CI=15.7, 18.3, P<0.001).
Current excessive drinkers were estimated to be HCV-infected 1.3 times more often (54.9%, 95% CI=43.2, 66.0) than those not infected (41.4%, 95% CI=40.0, 42.8, P<0.05). The researchers also found that excessive current drinkers were younger, less likely to have a usual source of medical care, and less likely to have received a diagnosis and told to stop drinking.
Emphasizing the importance of a diagnosis, a follow-up of NHANES correspondence found that 50.3% of those who had positive anti-HCV results in NHANES 2001–2008, did not know of their HCV status before NHANES notified them of their positive results. Of those who received notification of a positive result, 88% said their healthcare professional instructed them to limit alcohol consumption, however, their self-reported drinking was not much different from those who were not given this instruction, indicating the need for more comprehensive and effective interventions to target alcohol use in patients diagnosed with HCV.
"The implementation of behavioral screenings to identify at-risk drinking among both hepatitis C-infected and uninfected individuals could prevent alcohol abuse and serve as a platform to educate patients on the associated risks," concluded lead investigator Amber L. Taylor, MPH, from the Centers for Disease Control and Prevention's Division of Viral Hepatitis. "Targeted strategies should emphasize testing to increase hepatitis C awareness among undiagnosed people, prevent disease progression, and ultimately link those infected to curative lifesaving treatments."
For more information visit AJPMOnline.org.