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.
Finding from liver
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
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.
How the study was
They compared 8 767 people without hepatitis C to 218 people
with the disease. Hepatitis C is a virus spread through blood. Some 3.2 million
people in the US 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% of those with hepatitis C and 11% of those without the
infection died. 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 Health.
People infected with hepatitis
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 the numbers."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
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.
Moderate drinking up
risk of death
"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.