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Alcohol and progression
Sep 24, 2008

Is there any correlation between the amount of alcohol consumed and the progression of Hep C? I know that the catch phrase is "avoid alcohol". I have never had a drinking "problem" and have passed the stage in my life when getting drunk on weekends was a given. However, does "avoid alcohol" mean "Do not drink alcohol ever under any circumstance" or does it mean "one drink or two a week is OK". I recently read your response to someone who had responded to RBV + IFN treatment and had an SVR in which you indicated that 1 or 2 drinks a week would be acceptable. This is a standard recommendation that I would expect to hear from any responsible, mature person with no concerns about HepC. As for me, I have reduced my alcohol consumption to 1 or 2 drinks a week since I found out that I was infected. My viral load is quite high, the gt is type 1a and my liver scarring is low. Thus we have decided to delay treatment until something more effective against type 1a becomes available on the market. Will I do myself irreparable damage if I continue with my occasional drink, or should I really avoid alcohol altogether to be on the safe side? There probably haven't been too many studies regarding the correlation between ptrogression of liver fibrosis and the amount/time of alcohol consumption, but if you have any insight, please let me know. Thanks in advance.

Response from Dr. McGovern

Thank you for your important question.

There are strong data linking heavey alcohol use to fibrosis progression in HCV infection. Alcohol can also increase the levels of virus and depress the immune system.

However, these type of effects are described at 5 drinks a day.

No one knows how much is "safe". There are many people who think that one drink a day is probably safe. I personally recommend alcohol up to 1 to 2 drinks on the weekends for patients with moderate scarring; I think one drink a day is probably okay for patients with minimal disease. I recommend no alcohol for patients with severe disease.

This is just my best guess - no good data on this...



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