Assessing Prevalence of Alcohol Use and Association with Receipt of Direct-acting Antiviral Treatment and Sustained Virologic Response among Veterans with Chronic Hepatitis C at the Atlanta VA Medical Center Open Access

Wang, Yun Han Hannah (Fall 2018)

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To describe the prevalence of alcohol use in veterans with chronic Hepatitis C Virus (HCV) infection presenting for care at the Atlanta VA medical center (AVAMC) between 1/1/2015 – 11/29/2017 using alcohol biomarkers, ethyl glucuronide (EtG) and ethyl sulfate (EtS), and evaluate the association between alcohol use and receipt of direct-acting antiviral (DAA) therapy and achievement of sustained virologic response (SVR).           

Short Summary

Many veterans were ineligible for interferon-based therapy because of alcohol use. DAAs are safer and more effective, lifting historical alcohol abstinence requirements from national HCV treatment guidelines. Data are still limited regarding the impact of alcohol use on virologic outcomes in the DAA era.


Prevalence of alcohol use was determined using detectable values of EtG and EtS between 1/1/2015 to 11/29/2017. To determine association between alcohol use and receipt of HCV antiviral therapy and SVR, multivariable logistic regression analysis was conducted.  


Of the 1764 patients tested, 34% had detectable values of EtG and EtS. For those who used alcohol during study period, the odds of receiving DAA was 0.708 (95% CI: 0.574, 0.873; p=0.0013); the odds of achieving SVR was 0.719 (95% CI: 0.515, 1.004; p=0.0525).


Alcohol use during the study period decreased the odds of receiving DAA but had no statistical significance on odds of achieving SVR. Overall, 85.8% of patients who received DAA therapy achieved SVR. Patients with a history of substance or alcohol use disorders should be considered for HCV antiviral therapy DAA on a case-by-case basis. 

Table of Contents

Chapter 1: Literature Review

Chapter 2: Journal Article

Chapter 3: Conclusions


Tables and Figures

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