Decrease in Alcohol Consumption Improves Survival in Hepatitis C Infected Heavy Drinkers: A Longitudinal Cohort Study - Abstract
Background: Excessive alcohol consumption is common among patients with chronic hepatitis C and contributes to the progression of liver disease. Aims: The objective of this study is to determine the effect of decrease in alcohol consumption on survival of patients with chronic hepatitis C and excessive drinking. Methods: We conducted a retrospective cohort study of patients with excessive alcohol consumption enrolled in the hepatitis C clinic from August 15, 2000 through December 30, 2007 at the Veterans Affairs Medical Center in Houston. Survival was measured through August 30, 2011. Inclusion criteria consisted of hepatitis C infection and consumption of > 50 grams of alcohol per day, absence of complicated cirrhosis, and absence of malignant medical conditions. The primary outcome of the study was survival, analyzed by Cox proportional hazard model. Results: Two hundred eighty patients were followed for a mean of 6.34 years (SD 2.94). One hundred twenty two patients (44%) continued to drink above the risky drinking threshold and hundred fifty eight patients (56%) decreased alcohol consumption after a median of 2.73 (interquartile range: 0.34-5.26) years. Sixty six patients died. In Cox proportional hazards model, risky drinking (HR 1.58; CI 1.10-2.28), cirrhosis at baseline (HR 4.11; CI 2.38-7.10), and presence of medical co-morbidities (HR 2.65: CI 1.53-4.60) were associated with death. Conclusion: Cessation of, or decrease in, alcohol consumption improves survival in patients with chronic hepatitis C infection.