The impact of past alcohol use on treatment response rates in patients with chronic hepatitis C

Background: Studies have shown that past alcohol consumption reduces response rates in patients with chronic hepatitis C treated with interferon monotherapy. Aim: To clarify the importance of alcohol consumption on response rates in patients undergoing treatment with pegylated interferon and ribavirin. Methods: In a single centre, prospective study, median daily alcohol consumption (determined by previously validated method) and quartiles of alcohol consumption were calculated. Univariate and binary logistic regression analyses were performed using treatment response status as the dependent variable. Results: Overall, in an intention-to-treat analysis, 34 of 115 patients (30%) responded to treatment. In univariate analysis, black patients, especially those with hepatitis C virus genotype 1, high viral load and low alanine aminotransferase were significantly less likely to respond. Predictors of response by regression analysis included alcohol < 30 g/day (OR = 3.02, 95% CI: 1.02-8.93; P = 0.04), non-genotype 1 status (OR = 1.98, 95% CI: 1.03-3.80; P = 0.04) and non-black race (OR = 2.79, 95% CI: 1.33-5.85; P = 0.006). Conclusions: Median daily alcohol use > 30 g/day is associated with failure to respond to pegylated interferon and ribavirin for treatment of hepatitis C. Past alcohol use should be evaluated when considering treatment for hepatitis C.