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Hepatitis C and Alcohol- Does an Occasional Drink Hurt those with HCV?

Hepatitis C is a viral disease that affects the liver. Because the liver is responsible for breaking down toxins, consumption of alcohol puts additional stress on the liver. The most prominent risk factor for those with Hepatitis C developing cirrhosis and liver cancer is drinking alcohol. It has long been known that regular alcohol consumption significantly increases the progression of Hepatitis C.

Research shows repeatedly that heavy alcohol consumption is speeds the progression of Hepatitis C and makes conventional treatment less effective.

A case control study, published in 1999 Journal of Hepatology and performed in Italy, showed that the relative risk of HCC in patients with HCV infection and heavy alcohol consumption doubled. Finally, alcohol consumption potentially worsens the evolution of dermatological diseases associated with HCV infection such as porphyria cutanea tarda. All of the above are strong arguments which should be used to advise HCV patients against alcohol consumption, regardless of the degree of liver injury. (PMID: 10622572)

In May of 2000, research was presented that showed that there was a 1.5-2. 5-fold greater risk of liver cirrhosis and hepatocellular carcinoma (liver cancer) in the alcohol intake group of HCV patients compared to the alcohol-free group. Kruskal-Wallis analysis among four groups demonstrated a significant transition to fibrosis (P < 0.05) for alcoholics with HCV infection. The increased risk of liver cancer in the alcohol group is independent of size and growth of tumours. The clinical manifestations of gastro-oesophageal variceal bleeding, ascites, and encephalopathy were also higher in the alcohol intake group. They concluded that chronic HCV carriers should avoid excessive alcohol intake to reduce the acceleration of liver disease and risk of liver cancer. (PMID: 10869250)

In December 2005, research showed that HCV patients who abused ethanol had significantly higher risk of developing end stage liver disease compared to HCV patients who do not drink. Moreover, HCV-infected patients who abuse alcohol have extremely low response rates to IFN. (PMID: 16324217 )

With all the evidence that indicates heavy drinking is extremely detrimental to those with Hep C, still many people want to know, “Does an occasional drink hurt someone with Hep C?”

To be able to answer the question about social drinking and Hep C, and for the answer to really have an impact, it is important to understand how alcohol affects not only the liver but also Hepatitis C.

Let me briefly review some of the research available of Hep C and alcohol:

1. Experimental evidence suggests additive inhibitory effects between HCV and alcohol on antiviral immune responses. In other words, alcohol inhibits your body’s natural immune response to HCV. (PMID: 12530953)

2. Wen-Zhe 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.

3. Research has shown 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 conventional medication. There is a relationship between increased alcohol intake and decreased response to interferon (IFN) therapy, which may be reversed by abstinence. (PMID: 19387918)

4. In May 2009, evidence demonstrated that ethanol and chronic HCV infection synergistically accelerate liver injury. Acquisition and persistence of HCV infection may be due to the adverse effects of ethanol on humoral and cellular immune responses to HCV. (PMID: 19387918)

So, research clearly indicates that, NO AMOUNT OF ALCOHOL IS GOOD FOR THOSE WITH HCV, since any alcohol will cause virus replication and increase liver inflammation. Even occasional drinking should be avoided by those with Hepatitis C.