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DDW 2014: Drinking More Coffee Is Associated with Less Liver Fibrosis


People with hepatitis C who drink more cups of coffee per day may have a lower likelihood of developing advanced liver fibrosis or cirrhosis -- but only if it contains caffeine, and tea does not appear to have a similar effect, according to a study presented at the Digestive Disease Week (DDW 2014) meeting this week in Chicago.

Several studies have observed an association between coffee consumption and liver health, including improvements in fibrosis and fatty liver disease. But the mechanism underlying this effect -- and whether it is attributable to caffeine or other components in coffee -- is not clear.

As described at a Clinical Practice Distinguished Abstract plenary on Monday, Hashem El-Serag from Baylor College of Medicine in Houston and colleagues conducted a cross-sectional study looking at the association between liver fibrosis and self-reported consumption of a variety of beverages including caffeinated coffee, decaf coffee, caffeinated tea, green tea, herbal tea, regular soda, and diet soda.

The analysis included nearly 1000 U.S. veterans with hepatitis C, about one-third of whom had advanced fibrosis or cirrhosis (stage F3-F4). Almost all were men, just over half were black, and about 40% were white. Participants completed detailed questionnaires about their beverage choices, and liver fibrosis was estimated using FibroSURE and ActiTest (a non-invasive biomarker index).

The researchers found that overall coffee consumption -- but not consumption of decaffeinated coffee -- was inversely associated with advanced fibrosis. That is, people who drank more cups of regular coffee per day were less likely to have advanced fibrosis or cirrhosis. In all age groups, people with mild fibrosis drank more coffee than those with advanced fibrosis, though differences did not reach statistical significance in these smaller comparisons.

The association between coffee consumption and reduced fibrosis risk persisted in a multivariate analysis controlling for other factors including age, body weight, diabetes, and alcohol and soda consumption. Each additional daily cup of coffee was associated with about a 30% reduction in the likelihood of advanced fibrosis. Drinking more tea, in contrast, was not significantly associated with fibrosis severity.

While the correlation between drinking more coffee and lower likelihood of severe liver fibrosis does not necessarily indicate that coffee causes the risk reduction, the researchers concluded, "Coffee drinking is possibly protective against advanced hepatic fibrosis in HCV+ patients," adding, "The findings are suggestive of an important role for caffeine in explaining this observation."



H El-Serag, J Kuzniarek, DJ Ramsey, et al. Beverage Intake and the Risk of Advanced Fibrosis in HCV: Coffee, Tea, or Sodas? Digestive Disease Week (DDW 2014). Chicago, May 3-6, 2014. Abstract 775.