Excessive alcohol use increases the risk of morbidity and death in people infected with the hepatitis C virus (HCV), yet many of these patients were more likely to drink in excess — either now or in the past — than those without HCV infection, according to findings from a recent survey of U.S. households.
Adults infected with hepatitis C, indeed, were found to be three times more likely to consume five or more alcoholic drinks every day at some point in their lives than virus-free individuals.
The findings, in the article titled “Association of Hepatitis C Virus With Alcohol Use Among U.S. Adults: NHANES 2003–2010,” were published in the American Journal of Preventive Medicine.
“Alcohol promotes faster development of fibrosis and progression to cirrhosis in people living with hepatitis C, making drinking a dangerous and often deadly activity,” Amber L. Taylor, MPH, from the Centers for Disease Control and Prevention’s Division of Viral Hepatitis, and the study’s lead investigator, said a news release. “In 2010, alcohol-related liver disease ranked third as a cause of death among people with hepatitis C.”
To describe self-reported patterns of alcohol use and examine the association with HCV infection and other sociodemographic and health-related factors, researchers used information from the National Health and Nutrition Examination Survey (NHANES), and looked at hepatitis C infection rates for four groups: lifetime abstainers, former drinkers, non-excessive current drinkers, and excessive current drinkers.
Results showed that former drinkers and excessive current drinkers had a higher prevalence of HCV infection (2.2% and 1.5%, respectively) than those who never drank alcohol or were classified as moderate drinkers (0.4% and 0.9%, respectively).
HCV-infected adults also were 3.3 times more excessive, or heavy, current or former drinkers than those never infected with HCV (43.8% vs 13.7%). (The National Institute for Alcohol Abuse and Alcoholism defines excessive drinking as consuming five or more alcoholic beverages on a same occasion every day for five or more days in a 30-day span.)
A follow-up survey of participants, from 2001-08, who tested positive for HCV antibodies found that 50 percent were unaware of having been infected by the virus at some point prior to being notified by NHANES.
“Half of all people living with hepatitis C are not aware of their infection nor the serious medical risks they face when consuming alcohol,” said Taylor. “This highlights the need for increased diagnosis as well as comprehensive and effective interventions to link hepatitis C-infected individuals to curative treatments now available and provide education and support needed to reduce alcohol use.”
According to the U.S. Centers for Disease Control and Prevention (CDC), people born between 1945 and 1965 should be tested at least once for hepatitis C. Moreover, the CDC recommends that those who test positive be screened for alcohol use. “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,” Taylor concluded. “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.”
Excessive alcohol consumption causes an estimated 88,000 deaths each year in the U.S., shortens a person’s life by an average of 30 years, and carries an estimated $223.5 billion in economic costs.