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Another Reason for Hep C Patients to Abstain from Alcohol

Nicole Cutler L.Ac. February 3, 2011

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Most of us know that alcohol is not good for someone with the Hepatitis C virus. In addition to alcohol’s ability to speed up the progress of liver disease, there is now proof that drinking during antiviral therapy nullifies the effectiveness of Hepatitis C treatment.

There is little doubt that alcohol harms the liver. Accordingly, anyone newly diagnosed with chronic liver disease will receive instruction from his or her physician to completely eliminate the consumption of alcoholic beverages. Because the advice to change one’s drinking habits seems to accompany most health issues, its importance is easily lost on those for whom it is most important. Nowhere is the disregard for an alcohol abstinence order more troublesome than for those with the most common cause for chronic liver disease in the U.S., Hepatitis C. Alcohol is well-known to accelerate liver damage. Compounding alcohol’s danger, new research indicates that drinking alcoholic beverages during Hepatitis C therapy is likely to ruin any chance of a successful treatment.

Evidence indicating that drinking alcohol worsens Hepatitis C is abundant. Two examples, include:

  1. Based on a New York study published in the September 2007 edition of the Journal of Clinical Gastroenterology, alcoholics with Hepatitis C infection have more severe liver disease compared with non-drinkers who have Hepatitis C.
  2. As described in a 2009 edition of Digestive and Liver Disease – the official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver – there is evidence that alcohol abuse accelerates the progression of liver fibrosis and affects the survival of patients with chronic Hepatitis C. This appears to be due to a combination of the following four mechanisms:
    • Alcohol enhances viral replication
    • Alcohol increases oxidative stress
    • Alcohol induces cytotoxicity (cell death)
    • Alcohol impairs the immune response

The authors of this study concluded that abstinence from alcohol could prevent chronic Hepatitis C infection from progressing to advanced liver disease – when the chance of cirrhosis, liver cancer or liver failure is much higher.

It is easy for people with Hepatitis C to view alcohol as the least of their problems, and dismiss their doctor’s suggestions to completely cease drinking. As published in a June 2010 edition of the journal Drug and Alcohol Dependence, researchers from Philadelphia found that undergoing interferon-based treatment to eliminate Hepatitis C is definitely not a reason to be lax with alcohol abstinence. Currently, the standard treatment for Hepatitis C is combination therapy with pegylated interferon and ribavirin.

Their study investigated whether alcohol impaired the immune function of human liver cells, which would promote Hepatitis C infection and replication. The researchers found the following:

  • Alcohol suppressed natural interferon action in the liver. (Our immune system contains natural interferons to protect us against disease.)
  • Alcohol encouraged suppressors of cytokine signaling, which are negative regulators of interferon expression, thus impeding interferon action.

Based on their findings, the authors concluded that drinking alcohol contributes to the chronicity of Hepatitis C and the poor efficacy of interferon-based therapy.

Some people assume that as long as they are not an alcoholic, an occasional drink with Hepatitis C is OK. The evidence clearly indicates this assumption to be incorrect. Any bit of alcohol can worsen Hepatitis C infection and, for those who hope to clear the virus with interferon-based therapy, they shouldn’t even bother with the treatment if they plan on drinking any alcohol.

References:

http://www.ncbi.nlm.nih.gov/pubmed/17700425, Mechanisms of synergy between alcohol and hepatitis C virus, Singal AK, et al, Retrieved July 24, 2010, Journal of Clinical Gastroenterology, September 2007.

http://www.ncbi.nlm.nih.gov/pubmed/18602355, Alcohol and viral hepatitis: a mini-review, Gitto S, et al, Retrieved July 24, 2010, Digestive and Liver Disease, January 2009.

http://www.ncbi.nlm.nih.gov/pubmed/20646875, Alcohol impairs interferon signaling and enhances full cycle hepatitis C virus JFH-1 infection of human hepatocytes, Ye L, et al, Drug and Alcohol Dependence, June 2010.

http://www.substanceabusepolicy.com/content/2/1/4, Interferon alpha therapy for hepatitis C: treatment completion and response rates among patients with substance use disorders, Marilyn S. Huckans, et al, Retrieved July 24, 2010, Substance Abuse Treatment, Prevention and Policy, January 2007.

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