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Mortality risk greater among patients with HCV who drank alcohol moderately, heavily

Patients with chronic hepatitis C who drank a moderate amount of alcohol or more were at greater risk for death than controls and patients with HCV who did not drink in a recent study.

Researchers evaluated data on the average daily alcohol consumption of 8,985 adult participants collected from the Third National Health and Nutrition Examination Survey (NHANES III), along with the NHANES III Linked Mortality File. The cohort included 218 patients with chronic hepatitis C (CHC), with follow-up conducted for a mean of 178.27 months among controls and 162.95 months among patients.

Daily alcohol consumption was estimated using 10 g to represent one drink. Moderate consumption was classified as 1 g to 19 g per day; excessive was 20 g to 30 g per day; and heavy, 30 g or more daily.

Death occurred in 11.37% of the cohort, including 3.39% because of cardiovascular issues and 0.27% due to liver-related issues. The cumulative mortality rate was greater among patients with CHC than controls for all-cause (19.09% of cases vs. 11.22%) and liver-related mortality (6.37% vs. 0.15%), but not for cardiovascular-related death (1.66% vs. 3.43%).

Regardless of alcohol consumption, participants with CHC were at increased risk for overall (HR=1.91; 95% CI, 1.16-3.15) and liver-related death (HR=49.52; 95% CI, 12.37-198.26). In multivariate analysis these increases were more pronounced among patients who consumed moderate amounts of alcohol (HR=2.44; 95% CI, 1.59-3.75 for overall and HR=74.25; 95% CI, 19.62-280.92 for liver-related mortality). Those who reported excessive alcohol consumption were at the greatest risk (HR=5.12; 95% CI, 1.97-13.28 for all-cause and HR=183.74; 95% CI, 15.98-infinity for liver-related mortality). Investigators noted a trend toward increased risk for cardiovascular-related death as well (HR=3.34; 95% CI, 0.55-20.50).

“These results should inform clinicians to advocate complete alcohol abstinence in patients with CHC,” the researchers wrote. “Additionally, our study should inform health care policy makers to address CHC infection at the population level and recognize that CHC will not only increase the risk for liver-related mortality but also the risk for overall mortality.”