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.