 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Jennifer Vernon Campbell, MSPH, HIV/AIDS Epidemiology Program, Public Health - Seattle & King County, 106 Prefontaine Place South, Seattle, WA 98104, 206-296-7879, jennifer.campbell@metrokc.gov, Holly Hagan, PhD, NDRI, 71 West 23rd, 8th floor, New York, NY 10010, Mary Latka, PhD, Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, Richard S Garfein, PhD, MPH, Division of HIV/AIDS Prevention, Epidemiology Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-45, Atlanta, GA 30333, Elizabeth T. Golub, PhD, MPH, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 627 N. Washington Street, Baltimore, MD 21205, David L. Thomas, MD, MPH, Division of Infectious Diseases, Johns Hopkins School of Medicine, 424 N Bond Street, Baltimore, MD 21205, and Steffanie A. Strathdee, PhD, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205.
Background: Alcohol abuse is common among injection drug users (IDUs), accelerates liver disease among those infected with hepatitis C (HCV) and may be a contraindication for HCV treatment according to NIH guidelines. We measured problem alcohol use among anti-HCV-positive IDUs using the 10-item Alcohol Use Disorders Identification Test (AUDIT) and 4-item CAGE scales. Methods: Anti-HCV-positive, HIV-negative IDUs aged 18-35 years in Baltimore, New York and Seattle who were enrolled in a behavioral intervention study underwent computerized self-interviews to assess alcohol use and dependence and medical history. Problem drinking was defined as scores ³8 or ³10 on AUDIT and ³1 on CAGE. Results: Of 208 participants, median time since first anti-HCV diagnosis was 65 days (IQR: 9 days-1.7 years) and 78% recall counseling at diagnosis to reduce alcohol use. Eighty-four percent recognized as False: “It is safe for a person with HCV to drink alcohol”. Problem drinking was identified in 39% using AUDIT³8, 29% using AUDIT³10, and 42% using CAGE³1. CAGE questions related to cutting down (37%) and feeling guilty (26%) were most commonly cited. Seven percent of participants reported diagnosis of alcoholism; 39% and 36% had received support or treatment for alcohol use ever and in the last 6 months, respectively. Conclusion: Although most anti-HCV-positive IDUs in our sample appear informed about their increased risk of liver disease from alcohol, over one-third reported problem alcohol use. These findings underscore the importance of referring anti-HCV-positive persons to effective alcohol treatment programs to reduce future liver damage and assure HCV treatment eligibility.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.