Patients with chronic hepatitis C and advanced liver disease who
drink three or more cups of coffee per day have a 53% lower risk of
liver disease progression than non-coffee drinkers according to a new
study led by Neal Freedman, Ph.D., MPH, from the National Cancer
Institute (NCI). The study found that patients with hepatitis C-related
bridging fibrosis or cirrhosis who did not respond to standard disease
treatment benefited from increased coffee intake. An effect on liver
disease was not observed in patients who drank black or green tea.
Findings of the study appear in the November issue of Hepatology, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases.
Hepatitis C virus (HCV) infects approximately 2.2% of the world's
population with more than 3 million Americans infected. The Centers for
Disease Control and Prevention (CDC) cites HCV as the leading cause of
liver transplantation in the U.S. and accounts for 8,000 to 10,000
deaths in the country annually. Globally, the World Health Organization
(WHO) estimates 3 to 4 million persons contract HCV each year with 70%
becoming chronic cases that can lead to cirrhosis of the liver and
liver cancer.
This study included 766 participants enrolled in the Hepatitis C
Antiviral Long-Term Treatment against Cirrhosis (HALT-C) trial who had
hepatitis C-related bridging fibrosis or cirrhosis and failed to
respond to standard treatment of the anti-viral drugs peginterferon and
ribavirin. At the onset of the study, HALT-C patients were asked to
report their typical frequency of coffee intake and portion size over
the past year, using 9 frequency categories ranging from 'never' to
'every day' and 4 categories of portion size (1 cup, 2 cups, 3-4 cups,
and 5+ cups). A similar question was asked for black and green tea
intake. "This study is the first to address the association between
liver disease progression related to hepatitis C and coffee intake,"
stated Dr. Freedman.
Participants were seen every 3 months during the 3.8-year study
period to assess clinical outcomes which included: ascites (abnormal
accumulation of fluid in the abdomen), prognosis of chronic liver
disease, death related to liver disease, hepatic encephalopathy (brain
and nervous system damage), hepatocellular carcinoma (liver cancer),
spontaneous bacterial peritonitis, variceal hemorrhage, or increase in
fibrosis. Liver biopsies were also taken at 1.5 and 3.5 five years to
determine the progression of liver disease.
Results showed that participants who drank 3 or more cups of coffee
per day had a relative risk of .47 for reaching one of the clinical
outcomes. Researchers did not observe any association between tea
intake and liver disease progression, though tea consumption was low in
the study. "Given the large number of people affected by HCV it is
important to identify modifiable risk factors associated with the
progression of liver disease," said Dr. Freedman. "Although we cannot
rule out a possible role for other factors that go along with drinking
coffee, results from our study suggest that patients with high coffee
intake had a lower risk of disease progression." Results from this
study should not be generalized to healthier populations cautioned the
authors.
Journal reference:
Freedman et al. Coffee intake is associated with lower rates of liver disease progression in chronic hepatitis C. Hepatology, 2009; DOI: 10.1002/hep.23162
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