NEW YORK - For people with the chronic
liver infection hepatitis C, heavy drinking is an obvious no-no, but a new study
links even modest alcohol consumption with an increased risk of death - and not
just from liver disease.
"What this study shows is... truly, even what might be considered a
moderate and safe amount of alcohol use in people without hepatitis C is
dangerous to your health if you have hepatitis C," said Rae Jean
Proeschold-Bell, a hepatitis C researcher at Duke University in Durham, North
Carolina, who was not involved in the study.
The findings support what liver specialists typically recommend - that
people with hepatitis C should limit their alcohol use, said Dr. Zobair
Younossi, the study's lead author and chair of medicine at Inova Fairfax
Hospital in Falls Church, VA.
"Patients with hepatitis C should not really drink," he said.
But the reality is that people with hepatitis C have higher rates of
alcohol use than people without the liver disease, said Proeschold-Bell, who
studies interventions to reduce drinking among people with the disease.
Doctors have known that excessive drinking can exacerbate liver disease
caused by hepatitis C, but there's some debate about whether less frequent
drinking would have a similar effect.
Younossi and his colleagues looked to a large national survey on health
and lifestyle that tracked people for several years.
They compared 8,767 people without hepatitis C to 218 people with the
Hepatitis C is a virus spread through blood. Some 3.2 million people in
the U.S. have a chronic hepatitis C infection, according to the Centers for
Disease Control and Prevention.
The disease can cause serious liver damage, and while some people are
treated with medications, others will go on to require a liver transplant.
The survey tracked the participants for 13 to 14 years. During that
period, 19 percent of those with hepatitis C and 11 percent of those without the
Younossi's team found that people with hepatitis C who drank excessively -
three or more drinks a day - were five times more likely to die than heavy
drinkers who were not infected.
That result was not surprising, "We've known heavy drinking is
particularly bad if you have hepatitis C," Proeschold-Bell told Reuters
But people infected with hepatitis C who had up to two drinks a day were
also twice as likely to die during the study than those with similar drinking
habits who were not infected.
For the purposes of the study, a drink was equivalent to 10 grams of
alcohol, which is roughly the amount in four ounces of wine, 12 ounces of beer
or one ounce of hard liquor.
Younossi said the increased risk of death from liver disease is driving
"What is incredibly striking is liver-related death in patients with
hepatitis C who even drink moderately," said Younossi.
For instance, the risk of liver-related death among people with hepatitis
C who averaged two or fewer drinks a day was 74 times that of similar people
without hepatitis C.
Those moderate drinkers with the virus were also nearly three times more
likely to die of "all causes," the researchers report in the medical journal
Alimentary Pharmacology & Therapeutics.
"A drink a day is not OK," Younossi told Reuters Health. "Even a moderate
amount of alcohol use in the setting of hepatitis C can increase the risk of
death and liver-related mortality specifically."
Proeschold-Bell said there is a great opportunity for intervening with
people's alcohol use given that they are already interacting with the medical
system if they have a chronic hepatitis C infection.
"This is potentially very powerful, because if the person with hepatitis C
is already going in for medical care, they have some relationship with that
clinic. They have some degree of trust, so (perhaps) you can provide alcohol
treatment right then and there," she said.
Younossi said there's some evidence that if heavy drinkers without
hepatitis C abstain from alcohol, their liver disease can improve.
He said he suspects the same might be true for patients with the
infection, but that future studies will have to confirm that hunch. —