Finasteride and methadone use and risk of advanced hepatitis C related liver disease

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 (O_{Radj advanced fibrosis} = 0.75, 95 % CI 0.39-1.45 and O_{Radj 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.