Prospective ascertainment of alcohol intake poses fewer problems concerning memory than retrospective ascertainment, but this advantage is offset by the problems involved in long-term studies of rare chronic diseases. In addition, several studies have found

that heavy drinkers report higher alcohol intakes retrospectively than prospectively,20-22 which suggests that people are more comfortable reporting past heavy drinking than current heavy drinking. Because intense pressure on patients to reduce their alcohol intake before HCV treatment seemed likely to foster denial, we chose to study patients who had already been treated to reduce denial, and we emphasized that patients’ data would be kept confidential, even from their care providers. Test-retest reliability of the CLDH was not reexamined in this study, but internal validity was good. Patients with a CD diagnosis or CD treatment reported consuming approximately twice as much alcohol before HCV treatment as patients without CD records. It is possible that patients who did not obtain an SVR might have minimized their alcohol intake if they thought it might jeopardize their future treatment. However,

successfully treated patients had little reason to exaggerate their drinking, and the high alcohol intakes reported both by patients who did and did not recover suggests that denial did not influence these findings. In conclusion, excellent P/R treatment completion rates and outcomes were not impaired by high pretreatment alcohol intakes or failure to abstain 6 months before treatment in patients of an integrated health care plan who were aggressively supported and closely monitored. These findings suggest that past heavy drinking and recent drinking represent low treatment risk in these patients. The fact that over 60% of

patients stopped drinking when HCV+ was diagnosed documents the before potential for immediate health benefits associated with case finding in this population. The authors thank Boris H. Ruebner, M.D. (University of California at Davis, Davis, CA), for confirming biopsy findings in our cohort. The authors also thank Lilli Remer of the Prevention Research Center for assistance in programming the computer-assisted interview used in this study and deriving measures from it, Fred Johnson, Ph.D., of the Prevention Research Center, for assistance in data management and analysis, John Edwards of Kaiser Permanente Chemical Dependency Services for IT assistance, and Sonia Menenberg, R.N., of Kaiser Permanente Chemical Dependency Services for supervising our interviewer. “
“Hepatolenticular degeneration, commonly known as Wilson disease, is an Opaganib manufacturer autosomal recessive inherited disease of abnormal copper metabolism, characterized by the accumulation of copper in the body due to decreased biliary excretion of copper from hepatocytes.