Alcohol with treatment

The studies seem to concentrate on alcohol usage without treatment. Is there anything out there that defines moderate use during treatment?
I'm 2b on week 9 of 24, 800 mg Rebetol, and .05 of Per-intron weekly. My enzyme levels are coming down nicely, Bilirubin down to 1.2, viral load to be checked next month. I have a few drinks on the weekends, and if thats going to kill me, then I won't be posting here after that.

[Fubarcat]

Alcohol is bad for the liver whether or not you are on treatment.  You have NO IDEA how badly I've wanted just one glass of wine in the last 11 weeks, but I'm not going to do it.  I would suggest you give up the drinks for the duration of your treatment anyway.  I know it's hard, trust me, but why bother going through all this if you aren't going to give it your 100% effort.  Please try to stop the alcohol until after your treatment.  If you clear, then (although I am not advocating this, but . . .) drink very minimally thereafter.  I tend to agree with you that a few drinks during treatment may not kill you, but what's the point, really?  You are trying to help your liver as best as possible and clearly alcohol isn't your best bet, whether on treatment or not.

[thanbey]

Alcohol increases replication of the virus.

Treatment works to eliminate replication of the virus.

There is no known safe amount of alcohol for someone with hepatitis C, before treatment or after a successful course of treatment although, some doctors doubt that a glass of champagne at a wedding once or twice per year will cause a problem. That would be a moderate amount for someone with hepatitis C.

A moderate amount during treatment for hepatitis C is zero.

Alcohol is a proven liver antagonist for anyone independent of a viral infection. If you have any damage to your liver, a histological improvement is less likely if you use/abuse alcohol. (Ditto for smoking, by the way)

Few specialists will treat someone knowing that they are using alcohol, and fewer insurance companies will pay for it if they know you are working against the treatment. Is your doctor aware of your alcohol use? If so, you might ask him/her what s/he recommends for alcohol use during treatment.

If you cannot stop drinking, here is a resource that might help you to find some insight and help:

<a href="http://www.soberrecovery.com">online resource: recovery programs</a>

I hope this helps,

thanbey

[cuteus]

I did take a few last xmas, mimosas, just before the 24 wk mark.  Thank God it came back clear or I would have had major guilt trip.  I want to give this tx the best chance, and don't know how accurate a study I read was, but it stated that alcohol assisted in hcv replication.  with that in mind I mostly stay away from it during tx, i did take a sip of a Miller in Feb. but the best is to abstain,  don't want to give the buggers weapons of mass destruction, lol.

[cuteus]

BTW, my hepatologist did not fret when I told him about the intake, did not forbid it, either. mention it to yours and get HIS/HER input. GL

[nurse12hr]

Sorry to post here, but couldn't find the other thread about hepB. vaccination.

In the US (and I am assuming the UK), 30% of hep B cases occur with no "known" exposure at all.  

And you mentioned being monogamous and not an iv drug user--great!  But there is also a risk of exposure from health care workers (who may not follow your example).  The risk of HepB transmission during invasive procedures and dental work is well known.

I hope you don't think I am arguing with you--I, like so many others, don't agree with vaccinating a 1 day old newborn.  But the risk of contracting hepA and B is very real, and could be deadly to someone with hepC.  I think for someone with hepC, the risk of not vaccinating far outweighs the known risks of vaccinating. HepB vaccinations have been ongoing for 20 years or more.  

Again, your choice, your body.  But you did ask how else you could get hepB.  I was shocked that the number of cases without an identifiable exposure was so high.

[ellissg]

Thanks!!! It's nice to see just the science, not the morals.

My Doctor won't do a biopsy...........I'm on Coumadin and he is a "risk-reward" kind of a guy. Therefore, I don't know the extent of liver damage. I wish I did! It might make it easier to stay off the booze if I knew there was serious damage already. I have no symtoms (symptoms). It's not enlarged, the GGT has gone from 98 to 83; ALT 150 TO 66; AST 92 TO 52; BILIRUBIN 1.6 TO 1.2. I started out with a Viral load of 5.2 mil, and they won't take that again until the 12 week mark, April 15th.

[GwithHepC]

ellissg:

If you can't have a biopsy, you might want to checkout <A href="http://www.prometheuslabs.com/212j.asp?nav=products"> FibroSpect</a>: it is an alternative to biopsy that can tell you whether you have mild/moderate scarring or Severe scarring/cirrhosis.

G

[Galen]

Just got my weekly e-mail from the HCV Advocate ( http://www.hcvadvocate.org/ ) and there was a timely article on this very subject.  For the whole article and discussion go to http://www.hcvadvocate.org/news/newsRev/2004/NewsRev-39.html#9
---------------------------------------------
Light and Moderate Alcohol Intake May Have Minimal or No Effect on Fibrosis Development in HCV Infection

Heavy alcohol use contributes to liver disease in chronic hepatitis C virus (HCV) infection. Whether this is true for light or moderate alcohol use has not been shown.

Heavy alcohol consumption has been found in many studies to contribute to the progression of HCV-related liver disease. Patients with HCV are generally counseled by their physicians to abstain from drinking alcohol, despite the fact that light alcohol intake, which most patients practice, has not been shown to lead to worse liver disease.

Additionally, there is increasing evidence that light alcohol consumption produces significant health benefits. As such, researchers in the Department of Gastroenterology, University of California at San Francisco, San Francisco, CA sought to address how deleterious different amounts of alcohol intake are to patients with chronic HCV.

In this study, 800 patients with HCV undergoing liver biopsy at three sites had detailed alcohol histories recorded and the relationship between alcohol and hepatic fibrosis was assessed.

On univariate analysis, heavy alcohol use (>50 g/day) was associated with an increase in mean fibrosis (P = .01). Such an association could not be demonstrated for light and moderate alcohol use.

For each category of alcohol intake (none, light, moderate, and heavy), a spectrum of fibrosis was observed.

On multivariate analysis, age, serum alanine aminotransferase (ALT), and histological inflammation were the independent predictors of fibrosis (P = <.0001, .0003, <.0001, respectively).

In conclusion, write the authors,

[Indiana]

These alcohol posts almost always get "messy", but I'm gonna take a chance and post something to you anyways.
I have yet to see a study that tested "mild to moderate" alcohol use during tx. All the ones I have seen over the years I have researched have been about "alcohol abuse" using unreal amounts compared to what most of us would use. They all showed that it was bad. So....there is no real evidence for what you seek.
BUT...There IS some common sense stuff to think about. I agree totally with all that Thanby has posted here. You say you are lookin for some reason to not drink on tx?  OK....here we go....  
First off, lets start with why you're doing tx. You MUST have some REALLY good reason that pushed you to do this. Keep that in mind....  Not everyone is successful at this stuff. They do not really know exactly why some fail and some don't. It makes sense that one would want to do ALL they can to beat The Dragon. We all know that alcohol can be bad for the liver.....with or without Hcv. Makes sense to me that it would be kinda insane to add that fuel to the fire if you're trying to beat The Dragon.
IF you fail at this then 2 things happen.....You have just lost your BEST chance at beating this thing....AND You will ALWAYS wonder if YOU are the cause if you drank. That equals Depression and "Pissoffidness"(not a word) at yourself. You will live through the aftermath never knowing if YOU screwed this up or not.
IF you do fail at your first attempt your odds are NOT good for clearing this on the second attempt. They go WAYyyyy down for the subsequent attempts.
PLUS....how do yu feel right now? Feelin all "great and perky"? Hahahahahaha  I bet NOT. Do ya really want to take the chance that you have to go through all this AGAIN?....For a LONGER time??? I would bet NOT.
Then there are the sides. These sides CAN accumulate and become permanent for some. The longer you are on this stuff the worse it gets. Want to take that chance?
And all for what??....a few beers after work??  Is that really worth it? Just what is important here?
You want to kill the Dragon? HE doesn't get loaded and lay back. When you get high on alcohol and lay back......HE just gets REAL busy.....laughin all the way. He has help.....from YOU!
I was quite the drinker before I was diagnosed. I quit before I started tx. I CLEARED as a type 1b. I think my not drinking helped in that.
No....the al;cohol will not kill you on tx.....but it might let the Dragon kill you....in the end.  Sit back and THINK about it.
Best of luck................

[britgirl]

Thank you both for interesting bits of information. I had no idea about the Hep B infection rate statistics.....I guess I have been lazy about the vaccination as much as anything.No-one has been advising me to have it, whereas I have to have so many other ones (for travelling, mainly), typhoid, yellow fever, polio, tetanus, diptheria, Hep A.

As for the alcohol, I really do believe speed of replication depends on many things and alcohol is just one of them. Also, for me, it is a quality of life thing. While I agree with Indiana about giving up during tx (which I did) it seems to me that being able to have drink, while not good for your liver, may be good for your soul! To live the next thirty years without having wine with a meal would be very dull. I took the interferon in order to avoid such a prospect.

[harley dude]

Before I started tx 10 months ago, I had my personal Beer Fridge in my garage jammed packed with every kind of imported beer you can think of - I dared my wife to put soft drinks, milk or whatever(BEER ONLY FRIDGE)- In other words I enjoyed beer. I started drinking when I was 18, I'm 47 thats 29 years- I wouldn't drink till I got drunk I just enjoyed drinking beer, I guess it just eased the everyday tension of life, there were days I didn't drink, sometimes I'd go 5 or six days without drinking, but down here in Louisiana, there is a bar room on every corner, fairs, festivals, crawfish boils,fish fry hunting clubs, Mardi-Gras, Pig Roasts, It's like everything that goes on down here in Cajun Country people party and "Drink" for just about every ocassion. So when my doc said "NO MORE ALCOHOL"- I said oh S---!!!, But I stopped DRY, not a drop since I found out over a year ago- was it hard- Hell yes, My first barbecue without beer I burned everything, went to fairs and festivals and said(wow these things are really boring), went to Mardi-Gras and just wasn't the same, I feel stupid at Bike Night sitting on my Harley drinking Cherry Coke on the rocks. My whole point is It was hard, but you can stop and should stop while on tx and if you clear I'd still stay away from it for a while, think about all this stuff you are going through- give yourself the BEST chance of getting rid of this- JUST SAY NO- PS- My Beer only fridge is now filled with milk, soft drinks, yogart, fruit juices and NO more Beer>-- See ya Dude and do the right thing -STOP -- Harley Dude

[Tony-z]

Why is drinking any alcohol a big deal! We are talking about our lifes. Is alcohol (A Drug) that important to you. This should be such a simple answer, NO alcohol, No big deal if you want to stay healthy longer...

                  Tony

[locojo]

Your story sounds a lot like mine.  I really enjoyed drinking my beer.  Probably too much.  but when i showed up at the doctor with ast 550 and alt 740. I knew it was time to quit and then i found out I had hcv and it was a no brainer.  Now my asts and alt are in the 30s coincidence I dont think so.  Been 3 months wth no alcohol and I do miss it but  I will do without to kick thi sh$$$.

locojo

[Commdude]

Hahaha!

Yep, you're right.  Alot of social occasions down here in Cajun country do revolve around drinking.   Hate to say it's a part of the culture, but it is, and it is not hard to immerse oneself into that lifestyle...the poker runs...crawfish boils..outdoor music fests...etc..etc..

Alot of business actually takes place in bars around here.   Not to mention hanging around commercial divers - a crazy bunch to begin with.   Use to be that if you could hang with the boys partying, then you were "fit" to work offshore with them.   Party hard...work hard.  Part of it most probably has to do with being offshore for 30 days at a stretch, coming in after not having had a drink, then partying you ass off when back on the "beach".  Needless to say, having lived here for 12 years, dealing with the offshore industry, seems that alot of people do drink alot.

Having said all of that, however, and not to get moralistic, having a life-threatening disease that is aggrevated by drinking alcohol was enough for me to stop.  And I did.  Abruptly. It really was not hard.  Read enough studies to support that idea.  I have to confess that did "cheat", though, and did have a couple of beers during TX, but the treatment itself made beer, or anything for that matter, taste like ****!  The doc did say that a couple on the very odd occasion were OK, but it really made me feel worse than the treatment.   So that was it.

In any case, it is your bldy you are messing with and a hell of an expensive treatment plan, I would think, to mess with mixing any of that with drinking.

Just my own two cents worth for whatever that's worth these days.

[Ambush]

I enjoyed my glass or two of wine with dinner or at social occasions, believe me.  I quit alcohol the day I was diagnosed 18 months ago I was so damned scared.  And I sure do want to avoid that "pissoffidness" that Indy refers to :)  :)  :)
I hope I conquer this **** and can enjoy a glass again some day.  Normal would feel SO wonderful.  Time will tell.  I agree with britgirl on the QOL issue.  Of course, degree of liver damage is a big factor.  Hope you all have a peaceful evening.
ambush :)

[CARUU]

A different major event in my life got me to (for the most part) quit drinking about 6 years ago.  I'm thankful I didn't have that to struggle with when I was dx with hepc!  The dx alone was enough to almost send me over the edge:)  I hope to be back in a position of making a choice about having an occasional drink after tx, but I really don't consider it to be a choice for me right now.  I'm not (knowingly) doing anything to mess with my chance of SVR!

[Commdude]

Let's please do not turn this into a moral discussion.  I was speaking to Harley Dude.

Thanks, and have a great day!

[Galen]

Hey Tom!  Good to hear from you. I've wondered how you were doing.  I do my 6 month post-tx test next week.  I'll place odds that we both kicked dragon ass!

[locojo]

ROFL...You think that chevy has a diehard under the hood?

locojo

[Commdude]

Indiana....

As always, you do have a unique perspective on things.

I missed that part, and upon reading her response back...yep...it was constructive critism...and actually...kinda funny.  I did fail to mention the more pleasurable things to do......after a night on the town, of course....

Anyway, I am back to lurking....

BTW....will finally get the six month post tx test done next week - eight months post tx.   Thought it was an automatic appointment....waited for them to call...time went by...procrastinated...finally called the doc and scheduled the test.  Keeping all fingers and toes crossed.

[Commdude]

Thanks, Chevy!

All the best to you as well....

OK...now back to lurking

[Indiana]

Holy **** Commdude! NOW look what you've done! You've fired up the Chevy and she's almost ready to make a run to the coast! Ya mentioned guys, away from home for a month or more, and ready to party. Hell!...they probably have whiskers by then too!! She's not strong enough to resist THAT much temptation! Now her motors runnin! I suspect that she's already gassin up, checkin the exterior, and testin the traction where the rubber meets the road!
We may not see her now for awhile. If she comes back in here all calm and collected, we'll know she found her way there.
Perhaps there will be a video....."Chevy Gone Wild"!!!....or....."Whiskers on The WaterFront"!!

[Commdude]

Hi, Galen!

Long time!

Wow!  Time does fly.  How are you enjoying post tx life.  Nice to be back among the living, ey!    

Yep...next week is a biggie, indeed.  I go on Tuesday.  Suppose it takes about a week to ten days to get results back.  I feel pretty confident, since I remember how I felt before TX.  Feeling pretty spunky these days.

Let's keep each other posted.

[St. Georgie-Girl]

Bad Mix: Alcohol and Hepatitis C

No Safe Alcohol Levels if You're Infected

By Jeanie Lerche Davis
WebMD Medical News
Reviewed By Michael Smith, MD
on Friday, March 12, 2004

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.

SOURCES: Monto, A. Hepatology, March 2004; vol 29: pp 826-833.
WebMD Medical Reference in collaboration with The Cleveland Clinic:
"Alcohol and Your Heart."

[ellissg]

Lori:

You hit the nail on the head. Yes, I have posted this question before, and being an alcoholic, and unable to stop......(I have a few drinks, three or four nights a week-the truth be known).....I posted again in a pathetic attempt to get some justification for my stupid behavior. Thanks for your frank and honest post. I desperately need to get "slam dunked".

I will not waste space on this thread again, at least about my problem with alcohol, but I'll post after I get my 12 week results, for information only. That is 4 weeks away, and I SHALL ABSTAIN from all alcohol, and await the results of the VL test.

Many thanks to all!!! Wish me luck. I'm a pathetic and addicted old man, but I'm not a bad guy, and want to do this for my kids, Grandbabies, and my wonderful wife.

[Indiana]

HEY.....I hope you're not taking anything I am saying when I'm playin seriously. If I'm not talkin about Hcv then the rest is all in fun. If you don't find SOME way to have a little fun on this stuff you'll just sit around and go nuts!
Don't go gettin all serious on us.....or we just may have to send Balrog over there and you'll have to go save a Rainforest or something.

[britgirl]

Looking at your AST and ALT levels, they haven't gone down that fast, which may be cos of the booze, who knows? My ALT dropped from 135 to 37 in the first two weeks, and AST from 88 to 35, and they stayed there till the end of tx when they dropped to 15. I hadn't realised this was a real battle for you to give up -I thought you just liked the taste of the stuff. It must be hard, but to give it your best shot, I agree with the others about stopping. In any case, I wish you well in your 12 week PCR and will be interested to know the outcome.

[honey1616]

After reading your posts, I know it must be hard for you and such a struggle to break an old habit.  The not drinking during tx,,,doesn't really effect me that much as basically...I just enjoyed a glass of wine here and there so I haven't walked in your shoes.  Are you in the tx for 6 months or 1 year?  Is your wife supportive of you and helping you get through this period in your life?  Also...if you are having a real struggle or feel you can't get by....Call your dr and talk to him about what is going on.  One day down...and then you move to next day. That is only way you get through this and of course we are all here to help you and support you.  Good Luck!

[ellissg]

My wife is very supportive, but I'm away from home most of the time, working in another State. She would be very disappointed if she knew I was jepardizing my treatment. We probably spend one week together every 6 weeks, and when she's with me, I am a very good boy.

I'm very determined to do better. Thanks for everyone's support!

[hepcbilly]

That was a very touching and brutally honest post. I so admire your ability to be yourself without any qualms. Mr Billy has suffered from the same disease but has been clean 9 months since Dx. Don't ask me how he does it and he says he doesn't miss it anymore. I smoke and have struggled with that addiction for years. If I had hep I dont know that I could give that up, so I admire and respect how hard this is for you and the stuggle.Addiction is a very very difficult disease. I will pray for youand all of us afflicted with addiction. Have a great day ellissg and oh yeah shhot a prayer up to the big guy for my addiction too...

Chevy Chevy Chevy  You doing alright girly?

[audreywald]

Honey, you are a girl after my own heart. I like your humor and way of looking at life. How are you doing?

God knows, I could think of things to do besides drink to make myself feel better.

I have been clean and sober for over 18 years, drugs were my thing, but I KNOW any alcohol with Hep C or any liver disease is tempting fate at the very least.

The folks who are trying to find a way to still drink probably have a problem. I am not judging anyone, I still smoke cigarettes and I KNOW that is because I am addicted.

Be smart kids. Why not give up the booze and give your liver every chance to get better?

[cindee]

My 2 cents worth.......NO ALCOHOL........!!!!!! I gave my 48 wk tx 100%. No cheating, no missing pills or shots....I found out today I relasped. Before I would hunt a reason to drink..ya know like .....it's Tues...LOL... or whatever. Now today would be a very good reason to drink...but NO thanks. My life has very different values now.

Chevy and Indy...you two crack me up!!!!! Ya'll always have me ROFLMASO!!!!! Can we be best buddies...please????? LOL I do wish we could all meet someday...it would be a hoot...or "HOOTERS", that one was for Chevy!!!!!!! love ya'll, Cindee