Living with Hepatitis C: Is an Occasional Drink Okay?
Learn about the effect of alcohol on Hepatitis C, and whether or not
its consumption, in any moderation, poses risks for people managing the
virus.
by Nicole Cutler, L.Ac.
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.
Benefits
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
No Justification
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.
The Evidence
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:
1. 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.
2. 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.
3. 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.
References:
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.
http://www.hepatitis-central.com/mt/archives/2007/10/living_with_hep.html?eml=hepcen41
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