Bad Mix: Alcohol and Hepatitis C
No Safe Alcohol Levels if You're Infected
March 12, 2004 -- For people with hepatitis C, there may be no safe level of alcohol new research shows. While heavy drinkers have the most severe liver disease, even light or moderate drinkers put themselves at risk.
It's a word of caution, especially for middle-aged men with heart disease. Although alcohol in small amounts provides heart protection, this might not be true for all people.
The study appears in this month's issue of the journal Hepatology.
Many people infected with hepatitis C never develop serious liver disease, writes researcher Alexander Monto, MD, a gastroenterologist with the University of California at San Francisco.
Those most likely to have severe liver problems: older people, especially men who are heavy drinkers, and people with long-time hepatitis C infection.
However, this group of researchers wanted to know how light and moderate drinking affected liver disease -- given recent findings that a drink or two a day offers some protection against heart disease for some people.
For heart protection, no more than one drink per day for women and no more than two drinks per day for men are advised. One drink is equal to a 12-ounce beer or wine cooler, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.
No Safe Level Alcohol
In his study, Monto asked 800 people -- all with hepatitis C infection -- to complete a questionnaire about their drinking habits and their medical history.
He defined "heavy drinking" as more than two drinks daily; "moderate" meant one or two drinks daily; "light" was less than one drink daily.
As expected, heavy drinking was linked with more severe liver problems. In fact, there was no "safe" level of drinking, reports Monto.
- 47% of the heavy drinkers had serious liver problems.
- Liver disease risk increased at each level of chronic drinking -- even among people having less than two drinks a day.
- The damage was less than with heavy drinking, and may have minimal or no effect -- but the chance of damage was there.
Risk for women has not been investigated much until now, Monto notes. Women in his study did very little drinking -- with less than 50% drinking more than four drinks a week. Monto cautions against drawing firm conclusions on this data:
- In this study, women did not seem to have any higher risk of liver disease than men did.
- Light drinking did not worsen women's liver disease. Only 12% of women were heavy drinkers, but did not have more liver problems than the 88% who drank less or nothing.
- Among women who were heavy drinkers, there were varying levels of liver disease.
Overall, his study shows that some people may have greater susceptibility to alcohol's effects, Monto notes. Different drinking patterns -- such as binge drinking rather than daily drinking -- may play a role. Also, older people may be at greater risk.
His results may be somewhat skewed, since each patient reported his or her own medical history and drinking habits, he says.