TY - JOUR
T1 - Finasteride and methadone use and risk of advanced hepatitis C related liver disease
AU - White, Donna L.
AU - Hashmi, Ali
AU - Ramsey, David J.
AU - Kuzniarek, Jill
AU - Tavakoli-Tabasi, Shahriar
AU - Hashem, B. El Serag
N1 - Funding Information:
Acknowledgments This material is based upon work supported in part by a VA Clinical Research and Development Merit Review Award (H-22934, PI: H. El-Serag), the National Institute of Diabetes Digestive and Kidney Diseases (NIDDK) (DK081736-01 and DK078154-03, PIs, D. White and H. El-Serag, respectively) and the Houston VA HSR&D Center of Excellence (HFP90-020).
PY - 2012/11
Y1 - 2012/11
N2 - Aim We evaluated the association between two medications that alter bioavailable androgen levels, finasteride and methadone, and risk of advanced HCV-related liver disease. Background: Males have strikingly greater cirrhosis risk across disease etiologies, including hepatitis C virus (HCV) infection. Methods: In a cross-sectional study in HCV+ male veterans, we determined medication use by up to 15-year medical record review, and hepatic pathology by the FibroSURE-ActiTest (F3/F4-F4, advanced vs. F0-F3, mild fibrosis; and A2/A3-A3, advanced vs. A0-A2, mild inflammation). We performed race-adjusted and racestratified multivariate analyses. Results: Among 571 HCV+ males, 43 % were White and 57 % African-American. There were non-significant decreased risks with finasteride use (ORadj advanced fibrosis = 0.75, 95 % CI 0.39-1.45 and ORadj advanced inflammation = 0.74, 95 % CI 0.41-1.43). For methadone, there was a nonsignificant 41 % increased advanced fibrosis risk in Whites and 51 % reduced risk in AA. White male methadone-users had 2.1-fold excess advanced inflammation risk (p = 0.15). Conclusions: Our preliminary study results suggest finasteride use is not significantly associated with a decreased risk of advanced hepatic fibrosis or inflammation in HCV+ males. The ethnically-divergent results for methadone associated fibrosis risk and finding of potentially increased inflammation risk in White males suggests the need for additional research.
AB - Aim We evaluated the association between two medications that alter bioavailable androgen levels, finasteride and methadone, and risk of advanced HCV-related liver disease. Background: Males have strikingly greater cirrhosis risk across disease etiologies, including hepatitis C virus (HCV) infection. Methods: In a cross-sectional study in HCV+ male veterans, we determined medication use by up to 15-year medical record review, and hepatic pathology by the FibroSURE-ActiTest (F3/F4-F4, advanced vs. F0-F3, mild fibrosis; and A2/A3-A3, advanced vs. A0-A2, mild inflammation). We performed race-adjusted and racestratified multivariate analyses. Results: Among 571 HCV+ males, 43 % were White and 57 % African-American. There were non-significant decreased risks with finasteride use (ORadj advanced fibrosis = 0.75, 95 % CI 0.39-1.45 and ORadj advanced inflammation = 0.74, 95 % CI 0.41-1.43). For methadone, there was a nonsignificant 41 % increased advanced fibrosis risk in Whites and 51 % reduced risk in AA. White male methadone-users had 2.1-fold excess advanced inflammation risk (p = 0.15). Conclusions: Our preliminary study results suggest finasteride use is not significantly associated with a decreased risk of advanced hepatic fibrosis or inflammation in HCV+ males. The ethnically-divergent results for methadone associated fibrosis risk and finding of potentially increased inflammation risk in White males suggests the need for additional research.
KW - Drug addiction
KW - Epidemiology
KW - Hepatology
KW - Sex hormones
KW - Urology
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U2 - 10.1007/s10620-012-2231-3
DO - 10.1007/s10620-012-2231-3
M3 - Article
C2 - 22669204
AN - SCOPUS:84871607859
SN - 0163-2116
VL - 57
SP - 3004
EP - 3010
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 11
ER -