alcohol consumption and hep c

[browneyedgirl5]

My husband was diagnosed with Hep C 2 years ago, after receiving a blood transfusion in 1982, we came to the diagnosis accidentally. He received combination therapy for 48 wks and received a clean bill of health in November of last year. My question is he has now taken to having an occasional beer or two on the weekends. Our doctor did say that abstinence is best but the "occasional" drink isn't going to do any damage, but they can't say for sure. As hepatitis is a liver disease my stance is it can't be a "good" idea. I am worried sick and I don't think our family can go through those hardships again, we have a 7 yr old that had a hard time seeing daddy sick.
Thanks

[Anne1717]

Hi - I was just diagnosed with ACUTE Hep C first through an American Red Cross screen and then confirmed with follow up blood tests.  Now that it is certain I have it, I and my family am stunned since I absolutely have no risk factors whatsoever - NONE. I am a 52 year old woman who has never taken an illicit drug or engaged in risky behaviors and this is a recent infection so even at my age, I would remember anything odd over the last 6 months or so

I am sure this has happened to someone but I get the looks like - "yeah right!"

[cuteus]

please post in the upper threads, many more than me can see it and offer you some comforting words.
it does seem as if you know what the answer is to your concern...
best to you both

alcohol has been shown to aid HCV in its replication in a study or two. do a web search and show him that tx might be worthless while he is drinking. does his dr know?

[BUDDYA]

I am a new to this forum...My husband is going through treatment the 3rd time..He has Geno type 1A and stage 3 fibrosis..He is on trazadone..seroquel..xanax..and also has a mophine pump (due to 7 back surgeries many yrs ago and deterioting bones of his neck)he still wants to be able to drink as he says we only are here once and he has been going through so much  pain..We have only been married 1 1/2 yrs..and when i met him 1 yr prior to that he was diagnosed with Hep C..I thought we go through this together..but he is depressed...he smokes and drinks..but I am no way perfect..I have a drink with him..and I think I am getting sucked into his way of looking at it, and thats crazy...I dont know what to do..He gets more down when I ask him not to drink...I really dont know him that well, as he has had the disease ever since we met..and hes very fragile..I feel very helpless:(

[token]

I know what you mean, that's why I decided to wait for my next biopsy in 3 and a half years and new meds, I'm terrified of tx myself.. still, I can aford to wait, some people unfortunately can't :-(

I'm keeping my figers crossed, good luck!

What I meant earlier is whether there are any new research results that I haven't come across and it sounded as if you had read something when you said from the looks of it...

[Forseegood]

Hi Token! Good to see you too! Little confused about your question about more info? can you clarify? Anyway, yeah, getting ready to do tx, and yeah, going to it kicking and screaming, I'm not as level headed about it as so many are. Good to see you and Hep Cat, saw him somewhere here too!

[token]

hi, how r u? I'm back on the net... I was just catching up on the latest posts and noticed your last comment... could you please post the page where you read abt these latest treatment developments...txx!
What's happening w/ your treatment? When are you starting tx?

[Forseegood]

Hello!  I guess there are some who would of accuse me of beating this subject to death, but I thought I'd add one more post on this.

Firstly, please don't conclude that any of us were trying to tell you that your husband has a "problem" with alcohol... I say this at least for myself.

My own view about these boards is that they are for support, information "and debate" over various issues. It would be very strange if all of us were to have the same exact views on every subject. I figure others out there besides myself would find it helpful if they were to see differing views and opinions on any number of "controversial" subjects...such as drinking after SVR, to better come to their own conclusions on these matters.

The last thing I want to do is "personalise" these debates... or have someone personalise one of my opinions. These are only opinions, like you said, we're not doctors.  Even this thread changed my mind a little. It certainly wouldn't be helpful for me to have everyone completely agree with everything I say. My ego maybe. I, for one, always appreciate seeing many sides of an issue. One post in particular gave me a laugh out loud...I need that sometimes.

I would think that when we are talking about these types of issues, hopefully, it is more in the abstract. I certainly don't know your husband, his background, his character, nothing about him other than the fact that you said he was drinking a few drinks a week after SVR - and I went on to tell you some of my own thoughts on the subject. That's all. I'm no one to judge anybody- judging people on moral grounds? I'll leave that to the "higher ups" whomever and wherever they may me be. If anything I really wish you both well, and I'm always really glad to hear of anyone achieving SVR, couln't have been easy. Renews my hope...this is such a awful disease to have to condend with... boy do we know it.

And there have been some really interesting and thoughtful points made on this issue. I too lived in Europe for a time, and I'm very aware of the fact that wine and beer is so much a part of their lifestyle there...although in the past few years that seems to be lessening just a bit.

Maybe some of this goes to the fact that most of us wish we had our normal lives back? Those of us who have been impaired by this disease and have had to change our lifestyles... some radically? That means different things to different people, but I'm sure most of us would just like to have the old days back - before we were in the throes of this disease... where we could enjoy a good cab with dinner, or a beer at a backyard party, whatever. I'm not necessarily talking about alcoholics, there are many moderate drinkers...though this is an issue for some of us that maybe a few of us haven't addressed.

My contention is that I am probably forever changed by this disease...and I have no way of knowing exactly how and by how much, which is part of the problem regarding all of this. I am a biopsy grade 1, but I am having symptoms and I've had it close to 30 years. So maybe the disease isn't hitting my liver as hard as it has with other people, not yet anyway, but who knows what it's doing to other organs, glands, physiological systems?... it is a systemic disease as well as a liver disease... as many diseases are. Medical testing is only so sophisticated, comprehensive and precise, it can't pick up everything in degree or severity. I've learned this the hard way. The docs don't know everything that's going on in my own body due to this disease...and if they are good they'll be the first to tell you that. Unfortunately, medical science just isn't there yet. That's why I am very careful about what I put into my mouth, even what I smell or put onto my skin.

And even, God willing, if I got SVR, and my liver did get better from from the experience... what have the meds themselves done to me?  Let's all get real. Does anyone know for sure?... now or long term? Do I really want to hope it's all good and my body can take the added hit of routine alcohol drinking...six months after the meds? Maybe it can, it could happen, but I'm not willing to take that chance and I know that's my "own" personal decision.

Once they find something that will completely wipe out the virus in any and all forms, which might not be too far off from the looks of it...then I'll consider those decisions.

[couchpotato]

Could you please let me know the name of your travel agent? If you can make it to Hawaii and Amsterdam on $1,200., I want to go too. Maybe I'll throw in extra $50 and go to Mexico to sip on that icy Corona you're not going to have. Cheers! LOL

Mattie

[browneyedgirl5]

Thank you to all who have replied. I think some may have the wrong ideas about my question. I know my husband isn't on the road to alcoholism (I have worked in the field for years) I was just concerned about what an occasional drink (read 2 -3 maybe a week) could/would do in relation to the hep.
I never in a million years thought that it would get so many replies

[timlotus]

I wasn't sure whether to respond to the last post or not as this is supposed to be a supportive respectful low-stress forum, and the last thing I would want is to 'argue' with another member.

However I have noticed that several times when people (often Europeans like britgal) have raised the issue of choices not to abstain thay have been met with quite a bit of puritanical moralising, often with a self-righteous tone, and certainly making utterly unwarranted assumptions about motives for drinking alcoholic beverages. I don't find this supportive or evidence-based, and I think (obviously unintentionally) the starter of this thread experienced something similar.

Clearly if your drinking was 'madness', if your drinking was 'selfish and all about the drinker' and if you have tales to tell about 'stupid alcohol induced behavior' then probably quitting was a good move.

However I can say with complete honesty that I have never had any 'stupid alcohol related behavior'. Drinking wine in various countries and to complement the national food is a very important aesthetic, cultural and social activity for me. It is almost always highly enhancing of my life and friendships. I am not suicidal: I have come to the conclusion that I can probably continue to enjoy this if I get an SVR. I have come to this conclusion based on my personal experience and my reading of the research literature and by talking to hepatologists. If I get evidence that it may harm me (e.g if I relapse or further studies shed doubt on the safety of my choice) then I will give it up. But I do feel I and others have the right to make this decision without being considered 'crazy' or assumptions being made that drinking always constitutes an 'unhealthy habit' and that the only reason to drink is to use alcohol as a drug.  

As I say I have no wish to undermine or disrespect people's choices to give up alcohol because of problems they have had, or for other reasons.

[new-sojourn]

Hey, its your very own liver and if you want to continue to trash it w/unhealthy habits, go ahead.

The dx of hep c can be a death sentence or a wake up call.  It can be a catalyst to radical lifestyle changes for ever or just temp changes to get thru tx.

Being a veteran of the hippy drug wars and the yuppie wine world style,-and yuppies are the worst-they have legal, illegal and socially acceptable drugs-and alcohol is the most damaging and powerful drug in the good old usa today-all I can say is that why start the madness again once you've stopped drinking?

Drinking is selfish and its all about the drinker.  No one notices that I don't drink, that's the nature of alcohol.  b/ I sure notice them and the changes in them!

I don't care to be that self absorbed or selfish or waste the money on an alcohol lifestyle.  I don'y have the need to talk loud and boastfully for all to hear me.  I don't need to take hasty offense or give sloppy confessions.

I personally take $100 a month-that is no longer spend on alcohol-and every 12 months I take a major trip or 2-this year kona and amsterdam.

I would much rather bore them w/pix of my travels then be bored w/endless stories of stupid alcohol induced behavior.  i'm thankful that hep c forced me into major lifestyle changes.

On a purely personal level-I now think women over a 'certain' age' shouldn't drink.  It dries the skin, adds that soft fluffy stomach and tends to make women weepy or bitchy.  it just looks  wrong!  w or w/o hep c.

Alcohol advetising is seductive. Just the other day, we were watching a corona ad and I said to my hubby, 'man, I really want a corona and I never darnk beer when I did drink!'  That's how pervasive and tempting alcohol ads are.  In fact, that's why we decided to go to kona instead of cabo--no beer adds for hawaii!

[timlotus]

This link may be of interest: it's about steatosis and HCV.

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/steatosis.pdf

[timlotus]

Thanks, that seems another very important issue to consider. Considering your own experience and that of your mother, I think you give very balanced, tolerant and reasonable advice.

I believe 'steatosis' or 'fatty liver' while associated with obesity is also a particular risk for those with genotype 3 regardless of body mass, so it is something that ought to be assessed at biopsy routinely.

[LvdByGod]

here's another thing to think about also...drinking causes fat to build up in the liver... fat cells multiply and get larger in the liver and cause a "fatty liver".  fatty liver can keep the fibrotic liver getting worse even after loosing the virus... it has a way of moving a diseased liver on towards further damage and can keep the liver from recovering or even moving it onto cirhosis/cancer.

fatty liver is pretty common in overweight people and in people who drink...

the problem comes in for us when our livers are still inflammed and fibrotic from the hep c, even after we got rid of the virus... loosing the hep c virus doesn't guarantee to reverse all of the damage for people. testing shows some improvment after svr, in fibrosis for some people but not in others...
do we want to chance it that a few drinks could cause our liver to keep going into worse stages and grades and cirhosis, etc...?
    
so imagin a person who clears the virus but still has a damaged liver... the drinking can cause the fatty stores in the liver to become inflamed so the damage could CONTINUE... even in the absence of the virus...so, it's no longer the hepc continueing the damage at that point but now the alchohol...it's just about the damaged liver and being able to keep that liver from from further injury and death...

so the alchohol insults the liver in 2 ways...the first way is just the initial insult of the alcohol toxins that we drink and the other way is the alchohol causing fatty liver... certain things can keep our livers deterioring; like alchohol, certain drug use/abuse, fatty liver, etc...

here's an example: my mom was an alchoholic until her 40's when she stopped drinking completely... but 20 years later she died of cirhosis and liver cancer in her 60's... she stopped all drinking "20"yrs, before her death...

so why didn't the liver go on to get healthy once she stopped drinking...because she was very obese and the fatty liver kept the liver dieing...and here you would think once she stopped the reason for the damage, in her case alchohol, for us the hepc, that she would have begun to reverse damage...but no the fatty liver kept the damage going until the cancer got the best of it...fatty liver and anything that would continue our livers to progress is our "main enemy" once we get rid of the virus...

so the question to me would be if a person had "one" drink a week,let's say...is this enough to cause the liver to remain inflamed and fatty? i bet because the drs don't really know the answer to that... this is the reason for the differences in opinions. i'm guessing no great dr would tell his patients to go ahead and drink a little...  the really great drs probably play it safe and just say don't drink anything...because they just don't know what the one drink will do in each individual, and thier main concern for us is absolute health...

so like someone said we each have to weigh the facts and the unknown and come to our own conclusions as to what the alcohol is worth risking to us...is our need to drink more important than preventing the risk to cause damage...like someone said the people who don't care about alchohol probably will just take the saftey lane and the ones who really want to be able to drink again these are the ones who can really get into trouble with it...

my conclusion is if a person had liver damage on the biopsy...they shouldn't drink at all to be the SAFEST!!!

BUT IF THEY INSIST ON DRINKING AFTERWARDS I WOULD TELL THEM THAT, if they had really low damage like stage 0 or 1 they should wait for a year or so after complete svr so the liver may recover from the slight damage enough to be able to stand an occassional drink..

I WOULD SAY TO the folks with enough disease to be concerned about it (STAGE 2 AND ABOVE), THEY should just play it safe...no more than a few drinks a year perhaps wouldn't hurt, but if they have any swings toward addiction to alchohol they shouldn't even have the one drink at all...too much to risk...imo

it's all about concidering each individuals risk factors, combined...

an svr stage/grade 4, fat person, who used to be an alcholic, obviously has too much to risk to start up drinking in any way...a stage 0 or 1 after waiting at least a year for thier liver to repair having a special occassion drink is a whole different story....each of us have to weigh our own risks...

[jmjm530]

There is some older research that suggests cigarette smoking negatively effects SVR and some that suggest it effects fibrotic progression. Nothing recent on the cig/SVR.

-- Jim

[timlotus]

This post is not aimed to 'give permission' to drink or to discourage it. People must make their own risk assessment and act accordingly. Personally I gave up alcohol for treatment and will continue this for 6 months post. After that I will probably not abstain from moderate consumption of wine and beer unless I relapse in which case I will definitely remain abstinent.

Many UK doctors do not insist on complete abstinence even during treatment. Some do recommend it and nearly all inquire about heavy or daily use before prescribing treatment. Our National Institute for Clinical Excellence guidelines states that consumption of over 7 Units per week (about 5 beers or 2/3 of a bottle of wine) may be harmful to the liver and may interfere with treatment effectiveness.

This link gives a very fair assessment of the research evidence up to about 2002:
http://www.harmreduction.org/hepc/hepcreader/alcoholandhepc.html

There has been no evidence since then to show that low or even moderate levels of alcohol consumption do any harm, but it is sometimes difficult to know this because of the need especially in American research papers to include 'politically correct' statements at variance with what the research actually shows. This is in order to be 'acceptable' in the cultural climate. Monto et al (2004) show that light or moderate consumption is not associated with fibrosis progression (which accords with several other studies)and that statistically significant association is only reached with consumption of >50g per day, but the authors then make this nonsensical assertion:

[timlotus]

Thank you. That is exactly what I meant. I think we are well advised to look after our livers even after SVR to avoid further damage and to encourage healing. Anything more than moderate and occasional use of alcohol may threaten this.

I think your point about tobacco is also well taken.

Tim

[jmjm530]

Argal...Nicely said and I agree very much with your thoughts about "balance". It's easy to focus on "alcohol" -- and certainly anything more than an "occasional" drink -- is crazy. But what about the rest of one's lifestyle?

It's easy to focus on alchohol, but I hope no one out there is feeling safe totaling tea while smoking a pack of cigarettes a day. :) And what about things like diet, being overweight, exercise, other rx drugs, stress, etc. All these things effect our health and possibly to some degree our liver and tx response.


Timlotus... Thank you for your very informative and comprehensive report. I'd just like to add/clarify the implication of your last sentence. I agree the risk is the possiblity of accelerating drinking from occasional to heavy. However, I don't believe the risk is relapse of the virus, but rather more of a chance of long-term liver damage.

-- Jim

[Forseegood]

Hi, I think you make a really good point - I guess I put the flares out and maybe become too reactive because I have talked to too many Hep C patients who seem to be "really" interested in just how much they can drink after svr??? The relationship to alcohol is what needs to be examined, like you say. Your doctor could probably tell that it would just not be too much of an issue for you, hence he told you what you said. Ironically, the people who are probably the least interested in drinking are the ones that are given the okay to do just that. Glad to see that there are many sensible people on this board, on this issue and many others re hep c.

[artgal]

Hi -- I just had to throw my thoughts in as they seem so different from the other posts. My doctor told me 5 years ago when I was diagnosed with Hep C and had a biopsy showing grade 1 stage 0 that he did not see a problem with an occasional drink. He went so far as to say two drinks a week (preferably red wine -- those polyphenols and all) would be fine. He said he is very reluctant to tell this to most patients with Hep C as many have trouble with alchohol. I've never been very into alchohol (it always made my runs in the morning feel slower -- I am very drug-sensitive) so I didn't really heed this advice. But my understanding is that once clear and finished with tx (and having a liver in good shape) the occasional drink should be fine.
So to me, it is much more about one's relationship with alchohol and the state of one's liver that would determine whether or not moderate use of alchohol is acceptable.
As with most things in life, if the rest of the picture is clear, balance is everything in my mind.
How wonderful the tx worked for your husband. Best to you.

[HepCinLA]

Okay, email is on the way to you!!!

[HepCinLA]

Hey who's your doc at Cedars?  That's where I'm treating.

[doll face]

I agree that they were a little harsh here but for all it is worth I think everyone did have good intentions.

My doctor told me that since I had no liver damage that a glass of wine or a beer now and then would not hurt. I did not drink a drop during tx and have not since being off the meds 9 months now.

  I do know that my dad also treated for hep back when there were 3 shots a week. He cleared the virus and his doctor told him that once he has been clear for 6 months that it can not come back due to drinking.  He does drink 5-6 beers a week and is now 3 years clear. Just had a PCR done a month ago.  As long as he has no damage and he has been clear now for 9 months than in my opinion a few beers is not going to cause the hep to act up. You are either "Cured" or not.

Hep C is not caused by drinking. But, everyone knows that drinking is not good for your liver.

[v eggie dip]

thanks for your elequent words, after reading my post I am sure it did sound harsh.  I would never intentionally offend anyone and sorry it happened...