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Having a Beer After SVR

Nicole Cutler L.Ac. August 29, 2014

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After surviving the diagnosis, illness and treatment for Hepatitis C, those who are cured of this illness may once again be faced with a decision to drink alcohol.
Having a Beer After SVR

The first instruction typically given to anyone diagnosed with Hepatitis C is to abstain from drinking alcohol. This is logical, since Hepatitis C is a viral infection of the liver and alcohol is a known liver toxin. In order to prevent Hepatitis C from escalating to an advanced form of liver disease, those with this infection must squelch any desire to consume a beer, glass of wine or other intoxicating spirit. Completing antiviral therapy and successfully conquering the Hepatitis C virus definitely hinges on a commitment to avoid alcoholic beverages.

However, does the same rigid rule apply after successful elimination of this virus?

The Hepatitis C virus has proven itself to be a formidable foe. Hepatitis C:

  • can persist for several decades in the body without revealing any symptoms despite progressively injuring the liver.
  • can eventually produce vague symptoms like fatigue, depression, joint pain and sexual dysfunction.
  • puts those infected at risk for liver fibrosis, cirrhosis, liver cancer and liver failure.
  • has demonstrated extreme resilience to medical treatment, complicating the campaign to end its destruction.

Treatment and SVR

Today, Hepatitis C antiviral therapy has evolved to consist of a combination of medications taken from 24 to 48 weeks. With triple drug therapy, the success rate of clearing the virus has risen from approximately 50 percent up to 75 percent. However, new pharmaceuticals in development promise to eliminate Hepatitis C in 8 to 12 weeks with a 90 percent or higher success rate.

A successful Hepatitis C outcome is defined as SVR, or sustained virologic response. An SVR is attained when genetic material of Hepatitis C is undetectable six months after therapy is completed. The equivalent of becoming Hepatitis C negative, SVR greatly improves liver function, life expectancy and quality of life.

According to Sanjeev Arora, MD, a professor of internal medicine at the University of New Mexico Hospital Center for Digestive Diseases, “In general, once an SVR is attained (sic), the liver disease progression completely stops.” Although SVR is cause for celebration, becoming Hepatitis C negative does not completely remove the risks of future liver disease complications.

Alcohol and Hepatitis C

There is no doubt that drinking excessive quantities of alcohol harms the liver. A large study published in a 2004 edition of the journal Hepatology clarifies that any amount of alcohol can harm someone with Hepatitis C. Based on this study of 800 people with Hepatitis C, researchers found that, while heavy drinking was linked with more severe liver problems, there was no “safe” level of drinking for people with this virus.

The medical community has recognized that alcoholic beverage consumption accelerates the progression of liver fibrosis with chronic Hepatitis C. The reasons are fourfold. Alcohol:

  1. enhances Hepatitis C viral replication.
  2. increases oxidative stress.
  3. induces cytotoxicity (cell death).
  4. impairs the immune response.

Despite knowing that alcohol fans the flames of liver injury and negatively affects overall health, many who have recently attained SVR are hoping to finally be able to enjoy an alcoholic beverage.

Alcohol After Hepatitis C

All of the reasons given for abstaining from alcohol with Hepatitis C are still valid – even after eliminating the virus from the body. The viral particles may no longer be present, but alcohol will still pose a threat to the liver’s health. During the course of time someone was infected with Hepatitis C, damage to the liver could range from minimal to severe. Those who escaped with little liver damage have a better prognosis than the majority who lost functioning liver cells:

  • The good news is achieving SVR appears to stop the progression of liver disease.
  • The bad news is alcohol consumption injures the liver – thus putting remaining liver cells at risk of damage.

To date, there have not been any comprehensive studies on the effect of alcohol post SVR. Though, having an alcoholic beverage with any level of liver damage is a gamble.

There are several variables in deciding the relative safety in this indulgence:

  1. Liver Disease Severity – Those with liver disease that advanced beyond mild fibrosis are taking a risk by drinking alcohol. After all of the effort invested in defeating Hepatitis C, an occasional glass of wine has the potential to cause the same type of damage as the ousted virus.
  2. Alcohol Dependence – For some with Hepatitis C, abstaining from drinking alcohol is a challenge due to some level of addiction. Returning to its consumption can easily trigger an addiction relapse. Such a relapse can lead to excessive drinking which is dangerous for anyone – especially someone who has a liver recovering from Hepatitis C infection.
  3. Questionable Degree of Liver Damage – After attaining SVR, few physicians will advise a liver biopsy. Thus, it is difficult to determine the degree of liver damage. Because of this uncertainty physicians typically advise those who have beaten Hepatitis C to continue with alcohol abstinence.

Even with all of the evidence just presented, there may be some individuals who have attained SVR from Hepatitis C and still want to drink alcohol. Ideally, this should be discussed with a medical provider to be certain that alcohol won’t jeopardize that person’s health.

Everyone’s ability to handle alcohol is different. Although excessive alcohol consumption is nearly guaranteed to cause liver harm, light drinking (no more than two drinks per week) might be okay for some. On the other hand, a significant amount of liver scarring or other health issue could render having an occasional beer to be a high risk activity.

If you have beaten the Hepatitis C virus and have no detectable liver injury from the virus, then one glass of wine per month is probably okay. However, putting alcohol back into the playing field for anyone else that achieved SVR is risky. To sum up, a tremendous effort was made by those who conquered Hepatitis C – an effort that could be wasted by choosing to consume alcohol, a known liver toxin.

http://cid.oxfordjournals.org/content/early/2013/04/23/cid.cit234.abstract, A risk for hepatocellular carcinoma still persists long-term after sustained virological response in patients with hepatitis C associated liver cirrhosis, Aleman S, et al, Retrieved August 23, 2014, Clinical Infectious Diseases, April 2013.

http://www.ncbi.nlm.nih.gov/pubmed/14999703, Risks of a Range of Alcohol Intake on Hepatitis C-Related Fibrosis, A. Monto, et al, Retrieved August 24, 2014, Hepatology, March 2004.

http://www.healio.com/infectious-disease/gastrointestinal-infections/news/online/%7B5a089979-a1f9-44b9-a762-ee3524e707d1%7D/hcc-risk-persists-8-years-after-hcv-eradication, HCC Risk Persists 8 Years After HCV Eradication, Alemana S., Retrieved August 23, 2014, Healio, 2014.

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/HCV_Neg.pdf, HCV Negative: A Guide for Healthy Living without Hepatitis C, Lucinda K. Porter, RN, Retrieved August 23, 2014, Hepatitis C Support Project, 2014.

http://www.hepatitiscentral.com/mt/archives/2011/02/another_reason.html, Another Reason for Hep C Patients to Abstain From Alcohol, Nicole Cutler, L.Ac., Retrieved August 24, 2014, Hepatitis Central, 2014.

http://www.hepmag.com/articles/Post_SVR_2502_24227.shtml, Past the Finish Line: The Benefits of a Hepatitis C Cure, Benjamin Ryan, Retrieved August 23, 2014, CDM Publishing, LLC, 2014.

http://www.thebody.com/Forums/AIDS/Hepatitis/Q207770.html, Consumption of Alcohol After Treatment of Acute Hepatitis C, Barbara McGovern, MD, Retrieved August 23, 2014, TheBody.com, 2014.

http://www.webmd.com/hepatitis/news/20040312/bad-mix-alcohol-hepatitis-c, Bad Mix: Alcohol and Hepatitis C, Jeanie Lerche Davis, Retrieved August 23, 2014, WebMD, LLC, 2014.

http://www2.potsdam.edu/alcohol/InTheNews/MedicalReports/Cancer/Alcohol-and-Liver-Cancer.html#.U_oJdUu4nlI, Alcohol and Liver Cancer, David J. Hanson, PhD, Retrieved August 24, 2014, DJ Hanson, 2014.

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HepatitisCentral.com provides information regarding hepatitis and liver disease. Comments are available to the community in order to discuss these topics and obtain answers to questions through community members. The Editors at HepatitisCentral.com will not be responding to questions or comments posed in article comments.

  • Dan

    Current treatments are already 12 to 24 weeks in duration, and SVR is now determined at 3 months post-treatment, not six. Further, according to current data, SVR rates are already in the 90% (and higher) range for genotype 1, although more patients, time, and accompanying data will tell the eventual story.

  • I am no doctor and I am not trying to play one on this site but my buddy has been Hep-C free for about 12 years and loves to get hammered!! He goes to his liver doctor for routine check ups and has No liver damage and he is STILL Hep-C FREE!!!!

    • Jessica

      You can say you’re not trying to influence people, yet you continue to post the same thing. It just seems like discouraging drinking instead of encouraging drinking is the right thing to do on a forum for people recovering from or battling with Hep C, a liver disease. The simple fact is, despite your friend’a case, alcohol is a liver damaging drug.

  • Patsy

    I did the treatment, have remained SVR for 1 year and had no liver damage per biopsy and fibrotest. I can have a drink, dr said so…I don’t over do it though

  • Linda Smith

    Hey Adam your friend has no clue that he is probably hurting and even making his Liver worse. First there are several very expensive blood tests he probably hasn’t had, Like Hepatic liver function panel or my all time favorite Viral Load. Ok his Hep c is in remission, But he may have cirrhosis Liver cancer or fatty liver which is bad too. I contracted Hep c in 1985 Bad car accident with 11 blood transfusions. Then 12 years my primary care Dr had me tested. I’ve completed 2 rounds of treatment with the first one having it go away completely and 2nd one fining I have 2 geno types. All i’m saying if this guy is your friend Please get him to stop drinking. Good luck

    • adam

      Linda I’m NOT saying what he does is right!!……But HE DOES NOT HAVE CIRRHOSIS LIVER CANCER!!!! He NEVER even had Fibrosis with his Hep-C!! He still sees his gastroenteritis to update his liver functions and he has no liver scaring!

  • Mark Thompson

    What we also have to remember is that a lot of people who have become infected with Hepatitis C have done so as a direct consequence of addiction. It is never a good idea for a recovering addict to partake of any mood altering substances, even in small doses!

  • mark eize

    after 30 yrs of hepc and a liver transplant today I am officially a SVR! I owe it to solivir and my transplant docs putting me on it despite 3yrs of ineffective pegasys interferon on my new liver which got reinfected shortly after transplant! (it always does!) it is questionable how much damage my new liver endured from the virus in the 6yrs I struggled with ineffective treatment until Solivir finally did the trick! I feel better, more active and ready to live a long natural lifespan now! without the solivir killing that dragon I was on borrowed time, as a transplanted liver is very vulnerable to hep c damage! Solivir had some unpleasant side effects-mostly depression, but I:d do it again if I had to! thank you Gilead

  • al

    After many years of getting “hammered’ I stopped alcohol when I was diagnosed with HVC. I stopped everything, no pot, no drugs, no tobacco. What is a second chance worth?
    After going through many attempts of hellish treatments, my viral load is undetectable. My liver is stage 4.
    In the vast majority, alcohol was a factor in behavior that lead to Hep C to begin with.
    There is the perception and there is reality.

    • Sylvia

      I agree. I have a chance of taking Harvoni now, however, I am having major issues in quitting drinking, My husband and all friends drink, that is what we do, which I know is damaging in many ways. I am now depressed as I do not really want or seem to be able to quit drinking, however, feel I will greatly regret this in the future. I feel that a lot of damage to my liver may be due to drinking and not Hep C. Is there a way to find out? Ive been diagnosed for about 10 years with no symptoms and lead a healthy life otherwise. One doctor told me a few years ago that I will probably die of something else other than Hep C. Am I just imagining that?

      • Slyvia I WAS in the same boat BUT i CHOSE TO TAKE THE MEDS I have now been on Harvoni for almost 2 weeks I am around a lot of friends and family drinking!!!! it’s ESPECIALLY HARD STAYING SOBER during the weekends!!! I PRAY to GOD I can HOLD on another day!!!! I THANK GOD that this treatment does not have the DEPRESSING SIDE EFFECTS that Interferon Ribavani had!!!!! My Dr. gave Xanax to sleep…..

      • No name

        You need to take the med and lease leave drinking alone

  • wanna live

    Are you crazy! Not me I want to live! I just beat the hep c and want to live!

  • ted

    I’v been 3 years free of stage 4 hep c. My doctor told me if I was to drink I would be dead in 2 years. well I’v been drinking for all 3 years and my liver in not fatty and enzymes are normal. Just checked 3 months ago.People may call me stupid, but having a beer during a football game with friends is one of the fine things in life to me, or a beer after a hard days work is a fine thing to me.
    Doctors get paid to tell you not to drink or smoke. Have you ever noticed how many doctors drink and smoke?
    I’m not recommending drinking to anyone with live disease, that’s my choice . but i am enjoying life as I live it.

    • Dave Ogden

      Amen brother

    • Rick

      I was diagnosed with hepatitis C back in 97 I have went to the therapy and I have been free of hepatitis C for 15 years and I have had about a six pack of beer a month and I’m still here to talk about it I’m living life and enjoying it only thing I have is I have depression because of the interferon

  • Liandre

    I have not had a drink since 1990. I did not get tested for hepatitis C for sure until recently, and I pinpointed the date I was infected around 18 years of age, which means I have been infected 31 years. 23 of those years were alcohol free. I have had to take minimal prescription drugs for bipolar, most of which do not harm my liver. I have 0 fibrosis (.19) and my count is 700,000. I do the whole herbal thing whether it works or not. I came to be infected do to self medication for my bi polar. Street drugs and alcohol. I kicked them to the curb. There was another man who got was infected by the same person I was and he quit everything. He has low counts and spends his days camping and riding his Harley. The man who infected us has been dead from it for over 5 years. He would not quit the drugs. So you adults out there, the decision is yours.

  • Mom

    My daughter is wondering if near beer is considered an alcoholic beverage and if drinking some while taking Havani is dangerous. Any light on this matter will be appreciated. Mom

    • Kathie Kane-Willis

      Hi Mom, I would say that the doctors told me NO ALCOHOL while on treatment. Harvoni is treatment, and it would be so horrible for her to not get cured because of using alcohol during treatment. I would just say that. Docs were very clear about that.

      • james b

        i drank the near beer during my treatment on the weekends (HARVONI) i asked my doctor and she said it would be ok (it takes 9 non-alcohol brews(not beer) to equal 1 beer i just finished my treatment(12 weeks) 3 weeks ago and i am negative for hep c now after having hep c for over 10 years oh and i was undetectable after 6 weeks but did the 12 week plan. i also have hiv and undetectable from that as well. THANK GOD for the new meds out there now, good luck everyone.

        • Lori Rojas

          Hi James
          I was reading your responds to the questions. I was wondering if I could email you? I have some questions about all this and don’t feel comfortable being bashed on, and not looking for peoples opinions that do not have the disease.
          I would really appreciate it.
          Thx in advance .

    • RMAN56

      If you’re referring to alcohol free beer, it still has alcohol. It has 0.5% alcohol. Enough that you have to be 21 to drink it. I’m not much of a drinker at all, but to make sure, I’m asking my doctor if it’s okay to have a drink or a glass of wine at my best friends wedding reception, just to be sure. I did the Sovaldi/Moderiba treatment which worked in 12 weeks. I’m totally undetectable. However, while undergoing the treatment, I did not have a sip of any kind of alcoholic beverage.

      I repeat, I’m not much of a drinker so it wasn’t like I was giving up anything. I do take a lot of other drugs, HIV drugs, narcotics (Vicodin), benzo’s (Xanax), Tramadol (lightweight opioid that it barely makes the grade). It’s the amount of Tylenol in Vicodin that they worry about more than any of the drugs I am currently taking.

      Ultimately, my recommendation is to remain alcohol free during treatment. If it’s a concern to give it up for 12-24 weeks, than why bother going through the treatment?

      • Kevin

        Hello.I’m currently being treated with Harvoni and only 13 day’s left.I’ve been completely alcohol free 2 week’s before and all through treatment.No problem.But am on 0.5 Lorazepan twice a day and I had hurt my back right when I started treatment and was prescribed 5-325 Vicodin twice a day.My liver specialist was in agreement that this would not impede my treatment.So far so good.

  • Sally

    Hello, has anyone experienced brain fog, confusion, memory issues with the Hep C?
    Thanks, Sally

    • Mary

      Yes a bit, but has anyone with hep c suffered from low platlet counts?

  • Bunnie

    I have reached SVR. I found out I have HCV in 1991 from a blood transfusion I received in the 70’s after I bled out after the birth of my daughter. I also did not know at the time I had a rare bleeding disorder I inherited a genetic disorder from my father called Factor V Leiden, which causes you to possibly bleed out after surgeries, injuries, etc. I tried Interferon for six months and I have to say those were the most terrifying months of my life. I finally quit when my doctor told me with Genotype 1a my chances of achieving a cure with Interferon was less then 20%.
    I have been on Harvoni for the past five months. I quite consuming any type of alcohol in 1991 when I found out I had HCV. My liver levels remained low, my liver scans were clear until last year, when the radiologist saw something was wrong with my gallbladder. They operated immediately and my gallbladder had become so diseased it had attached itself to my bowel wall and liver, causing cirrhosis (scarring of the liver). I see a hematologist for the Factor V Leiden and he also screens my liver because he is also an oncologist and a very caring person.
    I have had to turn down alcohol so many times I cannot count. I knew alcohol raised your viral load substantially and caused liver damage. I finally decided, why in the world would someone want to drink alcohol with HCV, knowing they are potentially setting themselves up for cirrhosis, liver cancer, etc. I knew if I wanted to live longer alcohol and my body had to part ways. Now that I am SVR, I plan not to consume alcohol. Why would you do this if you have fought so hard to overcome this disease? Just going through Interferon treatment was horrific enough to help me realize I didn’t want to consume a substance that damages not only your liver, but kills brain cells and is the most toxic substance a pregnant woman can consume while pregnant.
    If you look at the studies of Fetal Alcohol Syndrome this may help you decide not to drink and get on Harvoni or another drug that will help you achieve SVR. If a fetus can sustain such horrific damage from alcohol, just imagine what it is doing to your body; especially if you already have liver problems. So, no I DO NOT recommend the consumption of alcohol after you achieve SVR or before. I want to live a long healthy, happy live and I don’t need a substance in my body that has long been one that has caused so much misery for so many and truly is one of the worst “drugs” out there that does more damage to your body then some of the drugs that the government has banned for so many years. After seeing children with legs like spaghetti, and having to wear a helmet because they continually bang their heads on the floor from their mother’s consuming alcohol. There is an excellent study done by National Geographic which went to Ireland and took pictures of children where the mother’s had consumed alcohol through different stages of their pregnancies. The pictures are dramatic and frightening. No woman should consume alcohol while pregnant and in fact both parents should stop any alcohol consumption about 3months before trying to get pregnant. Alcohol is a teratogen to sperm also, causing the sperm to break and causing birth defects. Look it up for yourself, then decide whether you want to continue to consume alcohol as a basic fact of life, or lead one free from this “teratogen” that most of American consumes. Just look under Teratogens and Fetal Alcohol Syndrome and you will see alcohol is at the top of the list. I am not a right wing Christian whatever, in fact I don’t attend church because my grandfather was a minister who abused my father. My faith in not consuming alcohol comes from a lot of study of the effects of alcohol on adults and children and the devastation it has in our lives.

  • morgan

    hello