Is direct antiviral therapy in patients with Hep C effective in patients with alcohol use disorder?

A study called OPERA-C, carried out in 26 liver clinics in Australia, examined the effectiveness of direct-acting antiviral (DAA) therapy for hepatitis C in patients with risky alcohol use compared to those without.

The research found that DAA therapy achieved similar rates of sustained virologic response (SVR) in both groups, indicating that alcohol use does not affect the effectiveness of the antiviral treatment.

The study involved 3,729 patients, with 2,624 being thoroughly analyzed. It was noted that patients with risky alcohol use often had more advanced liver disease, as evidenced by higher rates of cirrhosis and elevated liver fibrosis scores. Despite these findings, the majority of patients with risky alcohol consumption did not receive pharmacological treatment for alcohol dependence, even though a significant portion continued to drink heavily. The study also revealed a discrepancy in the treatment for alcohol dependence among these patients. Only a small percentage received anti-craving medications during their DAA therapy. This lack of treatment could lead to ongoing liver damage and potentially undermine some of the benefits of the hepatitis C cure.

In conclusion, while DAA therapy remains effective regardless of alcohol use, addressing alcohol dependence in these patients is crucial for improving liver health and long-term outcomes.

 

Clark PJ, Valery PC, Strasser SI, et al. Alcohol does not impact chronic hepatitis C treatment outcomes but increases risk for progressive liver disease: Findings from a prospective multicentre Australian study (OPERA-C). Drug and Alcohol Review. https://doi.org/10.1111/dar.13914

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