Prevention of liver fibrosis and steatosis progression among heavy drinkers with and without HIV after 30-day drinking-reduction program

Background This is the first attempt to assess changes in liver abnormalities before and after contingency management (CM) to reduce heavy drinking beyond 30-days of follow-up. Objective The main objective was to determine whether liver fibrosis and steatosis, measured using FibroScan, change significantly between baseline, 30-days, and 90-days among older adults who drink heavily at baseline, enrolled in the CM intervention for alcohol reduction. The secondary aim of the study was to assess whether the changes in liver outcome measures differ across alcohol consumption categories. Methods A prospective study ( ClinicalTrials.gov registry: NCT03353701 ) of 46 older adults (63% male, 76.1% Black, mean age = 56.4) with heavy drinking at the baseline, living with or without HIV infection was evaluated. A linear mixed-effects model was used to analyze the FibroScan Transient Elastography (TE for fibrosis) and Controlled Attenuation Parameter (CAP for steatosis). Results There were no significant changes in liver fibrosis and steatosis measures after 90-days of drinking abstinence among heavy drinkers with or without stratified TE or CAP values at baseline. Conclusions CM for drinking reduction may not be effective at least short-term prospective in preventing liver fibrosis and steatosis progression for subjects without severe liver disease at baseline.