Predictors of alcohol use on liver function among young HCV-infected injection drug users

A study in this month's issue of the Journal of Hepatology identifies predictors and effects of alcohol use on liver function among young HCV-infected injection drug users in a behavioral intervention.

Hepatitis C virus (HCV) screening can provide opportunities to reduce disease progression through counseling against alcohol use, but empirical data on this issue are sparse. Dr Steffanie Strathdee and colleagues from California determined the efficacy of a behavioral intervention in reducing alcohol use among young, HCV-infected injection drug users, and assessed whether changes in liver enzymes were associated with changes in alcohol consumption. Both the intervention and attention-control groups were counseled to avoid alcohol use, but the intervention group received enhanced counseling. Logistic regression, ANOVA, and continuous time Markov models were used to identify factors associated with alcohol use, changes in mean ALT and AST levels, and change in alcohol use post-intervention. The team found that 6 months post-intervention, alcohol abstinence increased 23% in both groups, with no difference by intervention arm. Transition from alcohol use to abstinence was associated with a decrease in liver enzymes, with a marginally greater decrease in the intervention group. On further analysis, the team found that those who used marijuana transitioned from alcohol abstinence to consumption more rapidly than non-users. Those who were homeless transitioned more slowly to alcohol abstinence, and those who had ever received a clinical diagnosis of liver disease transitioned more rapidly to abstinence. Dr Strathdee's team commented, "Although, behavioral counseling to reduce alcohol consumption among HCV-infected injection drug users had a modest effect, reductions in alcohol consumption were associated with marked improvements in liver function." "Interventions to reduce alcohol use among HCV-infected injection drug users may benefit from being integrated into clinical care and monitoring of HCV infection." J Hepatol 2011: 55(1): 45-52 30 June 2011