How Coffee Consumption Affects Drug Therapy for Hepatitis C

Peginterferon and ribavirin are drugs used for treating hepatitis C virus infection, which is resistant to routinely used drugs such as interferons. About 50 percent of patients suffering from hepatitis C respond to this treatment. A recent study examined the effect of consumption of coffee and tea on the response of patients with hepatitis C to treatment with peginterferon and ribavirin. It was found that patients with hepatitis C who consumed more than three cups of coffee per day responded to a combination of peginterferon and ribavirin treatment with twice more likelihood of improvement than patients who did not consume coffee.

About 70- 80 percent of people infected with hepatitis C continue to harbor the infection for a very long time. These people are at risk of developing cirrhosis and cancer of the liver. About 150 million people worldwide are suffering from this disease. If a combination of peginterferon and ribavirin treatment fails, these patients are left with no other treatment options. Hence, many studies are being conducted to identify the factors that improve the efficacy of this therapy. Many previous studies have shown that coffee retards the progression of various liver diseases. The researchers of this study evaluated the role of coffee in the outcome of “peginterferon plus ribavirin” therapy.

* This study was performed on 885 patients with hepatitis C, who had to be treated with “peginterferon plus ribavirin” therapy, as they failed to respond to the interferon therapy.
* By using a food frequency questionnaire, the amount of coffee and tea consumption was noted in all the participants before starting the therapy.
* The response to treatment was assessed by noting the viral load in the patients. The viral titer was measured by finding the amount of hepatitis C virus RNA in the blood of the patients. This measurement was taken 12, 20, and 48 weeks after the commencement of the therapy.

* Out of the 885 participants tested, 85 percent consumed coffee on a regular basis. About 15 percent of them drank three or more cups of coffee every day.
* Only about 50 percent of non-coffee drinkers tolerated the full dose of therapy compared to 61 percent coffee drinkers who drank three or more cups of coffee per day.
* With increasing coffee intake by the patients, there was a considerable decline in the hepatitis C RNA level in the patients’ blood.
* Drinking tea did not produce any beneficial effects.

Shortcomings/Next steps
The researchers of this study did not collect information regarding the caffeine level in the coffee consumed by the participants. Data collected on the consumption of coffee was self-reported by the patients, which is liable to bias. Moreover, the researchers did not check whether the participants continued consuming the same amount of coffee until the end of the study. Furthermore, all the patients involved in this study were non-responders to interferon therapy. Hence, the findings of this study cannot be generalized to all people suffering from hepatitis C.

This study has proved that coffee enhances the ability of the peginterferon and ribavirin therapy to kill the hepatitis C virus. However, coffee alone lacks the antiviral capacity. Coffee contains more than 1,000 compounds, and any one of these compounds may enhance the potency of peginterferon and ribavirin. The mechanisms of such a facilitator action must be identified. This study has also shown that tea lacks the beneficial effects observed in coffee. Since this study was conducted on a large sample size with accurate measurement of virological response, its results can be relied upon. Patients on peginterferon plus ribavirin therapy for hepatitis C must be advised to consume more coffee to ensure an enhanced response to the treatment.

For More Information:
Coffee Consumption is Associated with Response to Peginterferon and Ribavirin Therapy in Patients with Chronic Hepatitis C
Publication Journal: Gastroenterology, March 2011
By Neal D. Freedman; Teresa M. Curto; National Institutes of Health, Rockville, Maryland and New England Research Institutes, Watertown, Massachusetts

*FYI Living Lab Reports Are Summaries of the Original Research.

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