How safe is it to drink alcohol socially after you complete hepatitis C treatment with direct-acting agents (DAAs) and are considered cured?
Answer From Stacey A. Rizza, M.D.
Newer hepatitis C treatments, known as DAAs, haven't been in use long enough for research to answer this particular question. But as a general rule, anyone concerned about liver health should avoid alcohol.
A few studies already show that some liver abnormalities last for years after successful DAA treatment. At the same time, many older studies clearly show that alcohol worsens chronic hepatitis C-related liver damage and increases the resulting health risks in lasting ways. Here are some of the findings:
- Liver scarring (fibrosis). Chronic hepatitis C infection often causes liver fibrosis. This effect may last long after treatment. Even if you have little apparent fibrosis, drinking alcohol may worsen the scarring, just as alcohol causes liver damage in people without chronic hepatitis C.
- Infection relapse. It's possible, but rare, for hepatitis C infection to reappear after apparently successful treatment. Relapses usually occur in the first few months after blood testing to confirm that the virus is no longer detectable. Sometimes, however, a relapse becomes evident much later. Although the exact cause of relapse is unknown, the remote possibility that the infection may return is further reason not to drink.
- Liver cancer risk. Hepatitis C-related liver damage increases your risk of liver cancer. Fortunately, eradication of the hepatitis C virus via DAA treatment lowers this risk. It does not, however, reduce the risk to that of someone without a history of hepatitis C. Alcohol use is one of the factors linked to development of liver cancer after hepatitis C cure.
Jan. 22, 2022
Stacey A. Rizza, M.D.
See more Expert Answers
- Tran A, et al. Non-invasive diagnosis and follow-up of chronic infection with hepatitis C virus. Clinics and Research in Gastroenterology and Hepatology. 2021; doi:10.1016/j.clinre.2021.101771.
- European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C: Final update of the series. Journal of Hepatology. 2020; doi:10.1016/j.jhep.2020.08.018.
- Feldman M, et al., eds. Hepatitis C. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021.https://www.clinicalkey.com. Accessed Nov. 15, 2021.
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