Coffee consumption reduces side-effects in people on hepatitis C treatment

Drinking three or more cups of coffee a day reduced the incidence of self-reported side-effects by more than 80% compared to non-coffee drinkers in people co-infected with hepatitis C and HIV who were taking hepatitis C treatment, a French study has found.

The study adds to evidence that coffee could be a useful and cheap 'supplement' for people taking hepatitis C treatment and could considerably increase the rate of treatment success. A study published in June (Freedman) found that in patients with hepatitis C and not HIV, drinking three or more cups of coffee a day increased the likelihood of treatment success by 80%.

The HEPAVIH ANRS CO13 study is a cohort study of hepatitis C/HIV co-infected patients taking pegylated interferon/ribavirin hepatitis C therapy. For the present study, 106 patients were evaluated.

Patients were asked whether they drank coffee and, if so, whether they drank it occasionally or had one, two or three or more cups of coffee a day. They were also asked to report on whether they had experienced a list of 30 different symptoms that have been reported as side-effects of hepatitis treatment and to rate the degree of distress they caused.

Seventy-five (71%) of the patients were men, their average age was 44 and 80% had been infected with both hepatitis C and HIV through injecting drugs.

At the start of the study 86% of the patients were taking HIV treatment and had an undetectable HIV viral load, although 13% had a CD4 count below 200 cells/mm³. More than half (52%) of patients had severe liver fibrosis or cirrhosis (fibrosis grades 3-4).

The median number of self-reported treatment side-effects at baseline was three; 31% reported no side-effects and 25% reported over eight.

People drinking three or more cups of coffee a day were 81% less likely to report discomforting side-effects than people reporting none. The likelihood of reporting side-effects decreased by one-third (33%) between each category of coffee consumption (i.e. occasional drinkers had 33% fewer side-effects than non-drinkers, patients drinking one cup a day had 33% fewer than occasional drinkers, and so on).

After adjusting for gender, age and history of opioid use, which are known correlates of reporting a higher number of discomforting side-effects, the effect of coffee remained significant (36% decrease per increase in number of cups drunk).

The researchers comment that the effects seen could be due to caffeine combating the fatigue and lack of concentration and alertness often reported by patients receiving hepatitis C treatment. However 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, and previous studies have reported no benefit in drinking tea, which also contains caffeine, albeit at lower levels. The researchers suggest further research into the benefits of coffee consumption and/or caffeine.