Coffee drinking improves hepatitis C treatment response rate in mono-infected patients

Michael Carter
Published: 22 June 2011

Coffee drinking is associated with improved responses to hepatitis C therapy, US investigators report in Gastroenterology. After adjustment for other factors, drinking three or more cups of coffee per day increased the chances of a sustained virological response by 80%.

The study involved patients with hepatitis C mono-infection. All had taken hepatitis C therapy before but had failed to achieve a sustained virologic response.

“We observed an independent association between coffee intake and virologic response to pegylated interferon plus ribavirin retreatment,” comment the investigators.

It is already known that drinking large amounts of coffee is associated with lower levels of liver enzymes and slower progression of pre-existing liver disease.

However, the impact of coffee consumption on responses to hepatitis C therapy is unknown.

Investigators from Hepatitis C Antiviral Long-Term Treatment against Cirrhosis Trial (HALT-C) therefore wanted to see if drinking coffee affected outcomes of hepatitis C therapy with pegylated interferon and ribavirin after twelve, 20, 48 and 72 weeks.

All 855 patients had fibrosis and had already taken a previous course of unsuccessful hepatitis C treatment.

Re-treatment consisted of pegylated interferon plus weight-based ribavirin. The patients provided information about their diet, and 85% indicated that they drank coffee, with 15% stating that they consumed three or more cups each day.

Coffee drinkers had a higher hepatitis C viral load at baseline.

Nevertheless, after twelve weeks of therapy, patients who drank three or more cups of coffee each day had an average 2 log10 copies/ml  viral load compared to a viral load of 4.6 log10 copies/ml for non-drinkers (p < 0.001).

Patients who drank three or more cups of coffee were significantly more likely than non-coffee drinkers to have a treatment response at all time points.

A sustained virological response (an undetectable viral load six months after the completion of therapy, considered a cure) was seen in 26% of those drinking three or more cups of coffee each day compared to 11% of those who did not drink coffee.

After controlling for other factors known to have an effect on hepatitis C treatment responses, the investigators found that drinkers of three cups of coffee each day were significantly more likely to have a sustained virologic response than non-drinkers (HR = 1.8; 95% CI, 0.8-3.9; 0 = 0.034).

“These results suggest that coffee drinkers had a better response to treatment that was independent of other risk factors,” comment the investigators.

They cannot offer an explanation for the beneficial effects of coffee. There was no evidence that drinking tea had similar beneficial effects, and they speculate that caffeine may have role.

Although they conclude that drinking coffee was associated with a significantly better response to treatment, they write “future studies are needed to replicate this finding in other populations.

Reference

Freedman ND et al. Coffee consumption is associated with response to peginterferon and ribavirin therapy in patients with chronic hepatitis C. Gastroenterology 140: 161-69, 2011.

This report is also available in Portuguese.

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