Alcohol, hepatitis C screening and hepatic fibrosis in drug users

Di Nino F, Chaffraix F, Schaeffer M and Doffoel M

Background: In drug users, viral hepatitis C, alcohol abuse, and drug use are three interconnected public health challenges.

Methods: This study assessed the impact of alcohol on hepatitis C screening and hepatic fibrosis in this patient population. In total, 934 substance users were included and divided into three groups: Group A, alcohol use disorder only (n = 511); Group ISDU, intravenous and snorting drug users (n = 142); Group ISDAU, intravenous and snorting drug users with alcohol use disorder (n = 281). A FibroScan was performed first, after which participants were proposed to undergo screening for HCV.

Results: The HCV screening rate was significantly lower in Group A (62%) than in the ISDAU or ISDU groups (81% and 85% respectively) (p<0.001). The rate of HCV seropositivity was lower in Group A (4.4%), whereas it was significantly higher in the ISDAU group than ISDU group (42.3% vs 30.0%, p = 0.02). The rates of significant fibrosis and severe fibrosis were higher in Group A (34% and 21%) and the ISDAU group (29% and 18%) than in ISDU (15% and 7%) (p<0.001). While entering, in addition to the group, age, gender, smoking status (cannabis and tobacco), drug consummation, HCV seropositivity, and BMI as co-variables in a multivariate model, only age correlated with fibrosis (p<0.001). Considering age, there was no difference in impact among the different substances on the fibrosis score.

Conclusion: Alcohol consumption impacts the health status of drug users. It is thus appropriate to early identify alcohol consumption in drug users and consider alcohol as a risk factor for severe fibrosis and HCV transmission. Alcohol consumption warrants the strengthening of HCV screening and hepatic fibrosis assessment. 

Keywords:

Published on: May 22, 2019 Pages: 4-9

Full Text PDF Full Text HTML DOI: 10.17352/ojh.000002
CrossMark Publons Harvard Library HOLLIS Search IT Semantic Scholar Get Citation Base Search Scilit OAI-PMH ResearchGate Academic Microsoft GrowKudos Universite de Paris UW Libraries SJSU King Library SJSU King Library NUS Library McGill DET KGL BIBLiOTEK JCU Discovery Universidad De Lima WorldCat VU on WorldCat