Hep C, Liver Transplantation Outcomes Hindered by Alcohol Abuse
Antiviral therapy has been associated with improved outcomes in patients with hepatitis C virus (HCV) and alcoholic liver disease who undergo liver transplantation (LT). However, according to recent research, providers must continue to emphasize the importance of limited alcohol intake in this patient population.
Amanda Wieland, MD, of the UCHealth Hepatology Clinic in Colorado, and Gregory T. Everson, MD, FACP, of the University of Colorado, performed a search of existing literature using the database PubMed.
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They found that, although current antiviral therapies have resulted in virologic cure or sustained viral response (SVR) in more than 90% of cases, outcomes prior to or after LT can be significantly affected by heavy alcohol use. In fact, previous research has uncovered associations of both low and heavy alcohol use with more severe fibrosis.
Thus, despite successful antiviral therapy, patients with HCV who achieved SVR can still experience progression of liver disease due to the effects of continued alcohol use.
“Antiviral therapy in patients with HCV plus alcohol should improve pre- and post-transplant outcomes, but providers must remain firm in limiting use of alcohol to avoid progression of liver disease post HCV cure,” Dr Wieland and Dr Everson concluded.
Wieland A, Everson GT. Co-existing hepatitis C and alcohol liver disease: a diminishing indication for liver transplantation? Alcohol Alcohol. 2018;53(2):187-192. https://doi.org/10.1093/alcalc/agx101.