SAN FRANCISCO, Nov. 5 -- Moderate coffee consumption may help slow the progression of liver disease related to hepatitis C, according to an observational study.
Among patients with established liver disease,
those who drank at least three cups of coffee daily had a 50% lower risk of progression over 3.5 years, Neal D. Freedman, Ph.D., of the National Cancer Institute reported at the American Association for the Study of Liver Diseases meeting here.
The findings added to those from previous studies linking coffee intake to lower concentrations of liver enzymes and a reduced risk of cirrhosis, chronic liver disease, and hepatocellular carcinoma.
"The results showed an inverse association between coffee intake and liver disease progression," Dr. Freedman said in an interview. "This was an observational study, so we couldn't show a cause-and-effect relationship. It's possible that coffee intake could be a marker for another exposure."
The findings came from a study of 795 adults who had detectable hepatitis C viral RNA, had not achieved a sustained virologic response with peginterferon/ribavirin therapy, and Ishak fibrosis stage ≥3. All participants completed a food frequency questionnaire at baseline and 13 months.
Investigators evaluated multiple outcomes and their association with coffee or tea intake:
Ascites
Child-Turcotte-Pugh disease score ≥7 on two consecutive visits
Death
Hepatic encephalopathy
Spontaneous bacterial peritonitis
Variceal hemorrhage
≥2 increase in Ishak score on year 1.5 or 3.5 biopsy for patients with bridging fibrosis at baseline
Multivariate proportional hazards analysis (adjusted for baseline age, sex, body mass index, education, race/ethnicity, diabetes, Ishak fibrosis score at baseline, lifetime alcohol intake, usual tea intake, and total calorie intake) resulted in hazard ratios (95% confidence intervals) for coffee drinking relative to non-drinking of 1.21 (0.81 to 1.79) for < 1 cup; 0.71 (0.48 to 1.05) for 1 to <3 cups; and 0.53 (0.29 to 0.95) for ≥ 3 cups (test for trend p-value = 0.0005).
Tea consumption had no influence on liver progression (HR 1.03, 95% CI 0.90 to 1.18).
The inverse association between coffee drinking and liver disease progression did not vary by treatment, cirrhosis at baseline, general health at baseline, alpha-fetoprotein levels, albumin, AST/ALT ratio, bilirubin concentration, esophageal varices, or hepatic steatosis grade.
The study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases and Roche.
The authors reported no potential conflicts of interest.
Primary source: Hepatology
Source reference:
Freedman ND, et al "Coffee intake is associated with lower rates of liver disease progression in chronic hepatitis C: findings from the hepatitis C antiviral long-term treatment against cirrhosis (HALT-C) trial" Hepatology 2008; 48(4):1101A. Abstract 1778.
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