PARIS — Although sustained virologic response maintained a high level no matter the alcohol or cannabis consumption in a German registry, those who reported drinking alcohol in excess were more likely to be lost to follow-up, according to a presentation at the International Liver Congress 2018.
“Alcohol or cannabis consumption did not diminish cure rates,” Stefan Christensen, MD, from Center for Interdisciplinary Medicine, Munster, Germany, said during his presentation. “However, loss to follow-up is more likely in patients with current or former drug use compared to patients without any drug history and in patients with a high alcohol consumption.”
Using a German national multicenter non-interventional real-world registry, Christensen and colleagues looked at 7,747 patients with HCV who began therapy with direct-acting antivirals. The group was broken down into patients using opioid substitution therapy (OST; n = 739), patients with drug history but not using OST (n = 1,500) and patients without history of drug use (n = 5,508).
Christensen showed that 13.9% of the patients without a history of drug use consumed alcohol above the recommended limitations. In the group with drug history, 22.2% met that threshold and in the OST group, 25% met the threshold. Cannabis consumption mirrored these trends with 1.2% of those in the non-drug user group, 9.6% in the drug history group and 19.2% in the OST group reported using cannabis.
Christensen then showed the loss to follow up as stratified by drug and alcohol use. In the subgroups of drinkers, 7% of non-users, 10% of drug history and 15% of OST patients were lost to follow-up. In the alcohol stratification group, OST differed from non-users, but in all groups, loss to follow-up occurred primarily after treatment. Christensen attributed the slight dip in SVR in the OST group to this loss to follow-up, though the OST groups were all at 83% SVR or above.
Loss to follow-up “occurred mainly after end of treatment – more than 70% loss to follow-up was at end of treatment – so ... these patients still have a high chance for cure,” he said.
“Interestingly for patients consuming cannabis, there was no difference at all. It seems that cannabis was not a risk factor for loss to follow-up,” Christensen said.
The same seemed true for relapse and SVR rates. Although the OST and drug history groups had slightly lower SVR, there was little to no difference between those who used cannabis and those who did not.
“High SVR rates can be achieved in all patient groups ... especially in the group of patients on opioid substitution therapy and patients with former or current drug use,” Christensen said.
For more information:
Christensen S, et al. PS-036. Presented at: International Liver Congress; Apr. 11-15, 2018; Paris, France.
Disclosure: Christensen reports acting as a scientific consultant and/or speaker for AbbVie, Bristol-Myers Squibb, Hexal, Janssen-Cilag, Merck Sharp & Dohme, Reckitt-Benckiser and ViiV-Healthcare.