Living with Hepatitis C: Is an Occasional Drink Okay?
Conflicting research about alcohol’s benefits has cast a shadow of doubt over advice to completely abstain from drinking alcohol. For every article about the benefits of alcohol consumption, another seems to warn of its risks. The debate gets even trickier when deciding to drink an occasional glass of wine while managing Hepatitis C. Although there is no doubt that heavy alcohol use worsens Hepatitis C infection, many social drinkers wonder if this same warning applies to them.
Hepatitis C Progression
The majority of people with chronic Hepatitis C will never develop a major complication related to this disease. Because Hepatitis C is a slowly progressing virus, signs of hepatic inflammation don’t typically appear until 10-20 years after initial exposure. However, if undetected, ignored or untreated, Hepatitis C is more likely to develop into cirrhosis or liver cancer.
Once infected with Hepatitis C, the most prominent risk factor for developing cirrhosis and liver cancer is drinking alcohol. Compared to non-drinkers, regular alcohol consumption significantly raises the risk of developing cirrhosis and liver cancer from Hepatitis C. It is now known that alcohol use, even in socially accepted amounts, accelerates the course of liver disease.
Confusing the issue of social drinking, published studies are increasingly supporting consumption of alcoholic beverages. The touted health benefits of moderate alcohol consumption, defined as two drinks a day if you’re a male under 65, or one drink a day if you’re a female or a male over 65, include:
- Reduces risk of developing heart disease, peripheral vascular disease and intermittent claudication
- Reduces the risk of dying of a heart attack
- Possibly reduces risk of strokes, particularly ischemic strokes
- Lowers risk of developing gallstones
- Possibly reduces risk of diabetes
With such fantastic health benefits, even a person with Hepatitis C can find justification for infrequent or moderate drinking. However, these benefits do not apply to a person with any kind of chronic liver disease, especially Hepatitis C! If you identify with taking an occasional alcoholic drink with Hepatitis C, consider this perspective – being infected with Hepatitis C is like harboring smoldering coals in your liver. A sip of alcohol is like putting a drop of lighter fluid on those coals. While repeated dumping of lighter fluid will fuel an increasingly raging inferno, even a small amount can fan the fire. Drinking just a little bit of alcohol can push a low Hepatitis C viral load into the far upper registers.
Immunology researchers have demonstrated that alcohol promotes the proliferation of the Hepatitis C virus in human liver cells. By studying molecular mechanisms in cell cultures, Philadelphia researchers revealed the role of alcohol in aggravating Hepatitis C infection and interfering with drug treatment. “It was already known that habitual alcohol drinkers have higher blood levels of Hepatitis C virus, compared to infrequent drinkers, even when both are infected with the virus,” said Wen-Zhe Ho, M.D., the director of retroviral research at The Children’s Hospital of Philadelphia.
Three discoveries resulted from studying alcohol’s effect on the Hepatitis C virus:
- Nuclear factor kappa B – Ho’s research team clarified why alcohol consumption parallels high Hepatitis C viral loads. The researchers found that alcohol increases the activity of a protein called nuclear factor kappa B. Increasing the activity of this specific protein causes the Hepatitis C virus to replicate. Additionally, nuclear factor kappa B plays a role in hepatic inflammation.
- Interferon-alpha therapy – On a molecular level, the researchers found that alcohol interferes with the antiviral activity of interferon-alpha. By making interferon less effective against the virus, alcohol defeats the purpose of attempting viral eradication with medication therapy.
- Naltrexone – Another finding with potential implications for Hepatitis C treatment was that naltrexone, a drug used to help alcoholics avoid relapse, blocks the deleterious effects of alcohol in promoting Hepatitis C infection. According to Dr. Ho, both alcohol and morphine activate opioid systems present in liver cells. These systems produce natural opiates, which play a crucial role in drug and alcohol addiction. This process may explain why naltrexone, which blocks opiates from binding to their receptors on cell membranes, reduced the effects of alcohol on Hepatitis C viral replication. “These data strongly suggest that activation of the endogenous opioid system is implicated in alcohol-induced Hepatitis C expression,” the authors conclude.
Thanks to the research team at the Children’s Hospital of Philadelphia, there is no longer any confusion as to what amount of alcohol is acceptable for a person with Hepatitis C. Even though moderate alcohol consumption has been associated with some health benefits, any advantages are far overshadowed by alcohol’s acceleration of Hepatitis C viral replication. Unless you are deliberately trying to increase your viral load, no amount of alcohol is okay with Hepatitis C. While the virus is present in your body, avoid alcohol altogether.
Stoller, Eleanor Palo, et al., Alcohol Consumption within the Context of Hepatitis C, Alcohol and Alcoholism, July 2006.
www.alcoholism.about.com, Drinking May Worsen Hepatitis C Infection, University of Philadelphia News Release, About, Inc., 2007.
www.gastro.org, Hepatitis C, American Gastroenterological Association, 2007.
www.hepnet.com, Hepatitis C and Alcohol, Eugene R. Schiff, MD, Schering Canada, Inc., 2007.
www.mayoclinic.com, Alcohol and Your Health: Weighing the Pros and Cons, Mayo Foundation for Medical Education and Research, 2007.
www.nih.gov, Alcohol Increases Hepatitis C Virus in Human Cells, National Institutes of Health, 2007.
www.patients.uptodate.com, Hepatitis C and Alcohol, Sangik Oh, MD, Sanjiv Chopra, MD, UpToDate, Inc., 2007.
www.webmd.com, Bad Mix: Alcohol and Hepatitis C, Jeanie Lerche Davis, WebMD, Inc., 2007.