Slows Progression of Liver Disease in Hepatitis C Patients
with Advanced Fibrosis or Cirrhosis
chronic hepatitis C patients with advanced liver
fibrosis or cirrhosis who did not respond to interferon-based
therapy, those who drank 3 or more cups of coffee
per day had a 53% lower risk of liver disease progression
than non-coffee-drinkers, according to a study that
will appear in the November
2009 issue of Hepatology. A similar effect
was not observed among patients who drank black
or green tea.
Freedman from the National Cancer Institute and colleagues
examined the relationship between coffee consumption and liver
disease progression in individuals with chronic
hepatitis C virus (HCV) infection who did not respond
to standard treatment. In prior research, higher coffee consumption
has been inversely associated with incidence of chronic liver
disease in population studies, the authors noted as background.
study included 766 participants enrolled in the Hepatitis
C Antiviral Long-Term Treatment against Cirrhosis (HALT-C)
trial who had HCV-related bridging fibrosis
and failed to respond to antiviral therapy using pegylated
interferon plus ribavirin. Primary
results from the trial showed that long-term pegylated
interferon maintenance therapy did not reduce the risk of
liver disease progression.
the start of the study, HALT-C participants were asked to
report their typical frequency and amount of coffee consumption
over the past year, using 9 frequency categories (ranging
from "never" to "every day") and 4 portion
size categories (1 cup, 2 cups, 3-4 cups, and 5+ cups). A
similar question was asked about black and green tea consumption.
Participants were seen every 3 months during the 3.8-year
study period to assess clinical outcomes including ascites
(abnormal accumulation of fluid in the abdomen), hepatic encephalopathy
(brain damage), spontaneous bacterial peritonitis, variceal
hemorrhage (bleeding varicose veins), hepatocellular carcinoma
(liver cancer), increased fibrosis, and death related to liver
disease. Liver biopsies were taken at 1.5 and 3.5 years to
determine liver disease progression.
At baseline, people who drank more coffee had significantly
less severe steatosis (fat accumulation in the liver), lower
serum AST-to-ALT ratio, lower alpha-fetoprotein (a marker
for liver cancer), lower insulin and HOMA2 score, and higher
albumin levels compared with non-coffee-drinkers.
the follow-up period, results showed that participants who
drank 3 or more cups of coffee per day had a relative risk
of 0.47 -- or 53% less -- for reaching one of the predefined
rates declined with increasing coffee consumption, from 11.1
per 100 person-years [PY] for patients who drank none, to
12.1 per 100 PY for those who drank less than 1 cup a day,
to 8.2 per 100 PY for those who drank between 1 to fewer than
3 cups a day, to 6.3 per 100 PY for patients who drank 3 or
more cups a day.
researchers did not observe any association between black
or green tea intake and liver disease progression, though
reported tea consumption was low during the study period.
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
from this study should not be generalized to healthier people
without liver disease, the researchers cautioned.
National Cancer Institute, National Institutes of Health
(NIH), Rockville, MD; National Institute of Diabetes and Digestive
and Kidney Diseases, NIH, Bethesda, MD; Keck School of Medicine,
University of Southern California, Los Angeles, CA; New England
Research Institutes, Watertown, MA; Virginia Commonwealth
University Medical Center, Richmond, VA; University of Texas
Southwestern Medical Center, Dallas, TX; University of Michigan
Medical Center, Ann Arbor, MI; Saint Louis University School
of Medicine, St. Louis, MO; University of Connecticut Health
Center, Farmington, CT; University of California at Irvine,
Irvine, CA; Massachusetts General Hospital and the Department
of Medicine, Harvard Medical School, Boston, MA; University
of Washington, Seattle, WA.
Freedman, JE Everhart, KL Lindsay, and the HALT-C Trial Group.
Coffee Intake Is Associated with Lower Rates of Liver Disease
Progression in Chronic Hepatitis C. Hepatology. Published
online July 13, 2009. (Abstract).