A Randomized Controlled Trial of an Integrated Alcohol Reduction Intervention in Patients With Hepatitis C Infection

Area of Science:

• Hepatology
• Addiction Medicine
• Clinical Trials

Background:

• Hepatitis C virus (HCV) infection and alcohol use are significant risk factors for accelerated liver fibrosis.
• Limited randomized controlled trials (RCTs) have evaluated clinic-based alcohol interventions for HCV patients.

Purpose of the Study:

• To assess the efficacy of provider-delivered Screening, Brief Intervention, and Referral to Treatment (SBIRT) with and without integrated alcohol therapy in HCV patients.
• To compare alcohol abstinence and heavy drinking days between SBIRT-only and SBIRT plus alcohol treatment groups.

Main Methods:

• 181 HCV patients with qualifying alcohol screener scores were randomized into two arms: SBIRT-only or SBIRT plus 6 months of integrated alcohol therapy.
• Alcohol use was assessed using the timeline followback method at baseline and 3, 6, and 12 months.
• Coprimary outcomes included alcohol abstinence at 6 months and heavy drinking days between 6 and 12 months.

Main Results:

• Both groups showed an increase in alcohol abstinence and a decrease in heavy drinking days from baseline to 12 months.
• No significant differences were observed between the SBIRT-only and SBIRT plus alcohol treatment groups for alcohol abstinence (P=0.70) or heavy drinking days (P=0.30).
• Average weekly alcohol consumption also decreased in both arms without significant between-group differences.

Conclusions:

• HCV patients are receptive to alcohol treatment when encouraged by liver medical providers.
• Provider-delivered SBIRT and tailored alcohol treatment referrals can be integrated into standard liver clinic care.
• While both interventions improved alcohol use, integrated therapy did not offer additional benefits over SBIRT alone in this cohort.