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

Dig Dis Sci. 2012 Nov;57(11):3004-10. doi: 10.1007/s10620-012-2231-3. Epub 2012 Jun 5.


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 race-stratified multivariate analyses.

Results: Among 571 HCV+ males, 43 % were White and 57 % African-American. There were non-significant decreased risks with finasteride use (OR(adj advanced fibrosis) = 0.75, 95 % CI 0.39-1.45 and OR(adj advanced inflammation) = 0.74, 95 % CI 0.41-1.43). For methadone, there was a non-significant 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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • 5-alpha Reductase Inhibitors / administration & dosage*
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Finasteride / administration & dosage*
  • Hepatitis C / complications*
  • Hepatitis C / epidemiology*
  • Humans
  • Liver Diseases / epidemiology*
  • Liver Diseases / etiology*
  • Logistic Models
  • Male
  • Methadone / administration & dosage*
  • Middle Aged
  • Narcotics / administration & dosage*
  • Risk Assessment
  • Risk Factors
  • Texas / epidemiology
  • Veterans


  • 5-alpha Reductase Inhibitors
  • Narcotics
  • Finasteride
  • Methadone