Heavy drinking takes excessive toll on women with hepatitis C

Women tend to survive longer than men if infected with the liver-destroying hepatitis C virus (HCV) - but if they drink heavily, that survival advantage completely disappears, according to a new study.

"Previous studies indicated that alcohol use is a risk factor for HCV disease progression, but they seldom examined the effect on women and men separately," said lead author Chiung Chen. "Even fewer studies were able to examine the effect of alcohol on HCV mortality. Our study provides empirical evidence to fill the gap."

Chen is a research analyst at CSR Incorporated, which conducted the study under contract with the National Institute on Alcohol Abuse and Alcoholism. The study appears in the February issue of the journal Alcoholism: Clinical and Experimental Research.

The study examined all of the HCV- and heavy-drinking-related deaths in the Multiple Cause of Death files of the National Center for Health Statistics, a total of 132,468 deaths. Women with hepatitis C who were not heavy drinkers died at an average age of 61 -- but those who drank excessively died, on average, at just over 49. For men, hepatitis C in combination with heavy drinking lowered the average age of death from a little over 55 years to 50.

Chen said evidence from previous studies "indicates that men are less likely to clear acute HCV infection than women, so we are a little bit surprised that the slight advantage for women is completely wiped out by heavy drinking."

"The study has the advantages of being massive and of relatively simple design, and applies epidemiological tools not much previously used on this question of HCV, heavy alcohol use and gender relationships," said Alex DeLuca, M.D., who is not associated with the study. "I think the most important findings are the ones that confirm our general understanding from clinical experience and other research approaches."

DeLuca, former chief and medical director of the Smithers Addiction Treatment and Research Center in New York City, said that the research supported earlier findings that women with hepatitis C generally have a slower progression of the disease, but that heavy drinking is in general harder on women than men.

The authors say a study limitation is that treatments like interferon, antiviral medications and liver transplants are often denied to heavy drinkers because they are less likely to be able to benefit -- but this could also contribute to their early deaths. - Center for the Advancement of Health