TY - JOUR
T1 - Predictors and effects of alcohol use on liver function among young HCV-infected injection drug users in a behavioral intervention
AU - Drumright, Lydia N.
AU - Hagan, Holly
AU - Thomas, David L.
AU - Latka, Mary H.
AU - Golub, Elizabeth T.
AU - Garfein, Richard S.
AU - Clapp, John D.
AU - Campbell, Jennifer V.
AU - Bonner, Sebastian
AU - Kapadia, Farzana
AU - Thiel, Thelma King
AU - Strathdee, Steffanie A.
N1 - Funding Information:
This work was supported by funding from NIDA (R01 DA14499).
PY - 2011/7
Y1 - 2011/7
N2 - Background & Aims: 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. We determined the efficacy of a behavioral intervention in reducing alcohol use among young, HCV-infected injection drug users (IDUs) (n = 355) and assessed whether changes in liver enzymes were associated with changes in alcohol consumption. Methods: 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. Results: Six months post-intervention, alcohol abstinence increased 22.7% 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 (p = 0.05 for ALT; p = 0.06 for AST). In multivariate Markov models, those who used marijuana transitioned from alcohol abstinence to consumption more rapidly than non-users (RR = 3.11); those who were homeless transitioned more slowly to alcohol abstinence (RR = 0.47); and those who had ever received a clinical diagnosis of liver disease transitioned more rapidly to abstinence (RR = 1.88). Conclusions: Although, behavioral counseling to reduce alcohol consumption among HCV-infected IDUs had a modest effect, reductions in alcohol consumption were associated with marked improvements in liver function. Interventions to reduce alcohol use among HCV-infected IDUs may benefit from being integrated into clinical care and monitoring of HCV infection.
AB - Background & Aims: 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. We determined the efficacy of a behavioral intervention in reducing alcohol use among young, HCV-infected injection drug users (IDUs) (n = 355) and assessed whether changes in liver enzymes were associated with changes in alcohol consumption. Methods: 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. Results: Six months post-intervention, alcohol abstinence increased 22.7% 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 (p = 0.05 for ALT; p = 0.06 for AST). In multivariate Markov models, those who used marijuana transitioned from alcohol abstinence to consumption more rapidly than non-users (RR = 3.11); those who were homeless transitioned more slowly to alcohol abstinence (RR = 0.47); and those who had ever received a clinical diagnosis of liver disease transitioned more rapidly to abstinence (RR = 1.88). Conclusions: Although, behavioral counseling to reduce alcohol consumption among HCV-infected IDUs had a modest effect, reductions in alcohol consumption were associated with marked improvements in liver function. Interventions to reduce alcohol use among HCV-infected IDUs may benefit from being integrated into clinical care and monitoring of HCV infection.
KW - Alanine aminotransferase
KW - Alcohol use
KW - Asparatate aminotransferase
KW - Behavior change
KW - Hepatitis C virus
KW - Injection drug users
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U2 - 10.1016/j.jhep.2010.10.028
DO - 10.1016/j.jhep.2010.10.028
M3 - Article
C2 - 21145862
AN - SCOPUS:79958802105
SN - 0168-8278
VL - 55
SP - 45
EP - 52
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 1
ER -