Drinking Alcohol Post SVR

This topic has 41 replies, 13 voices, and was last updated 8 years, 5 months ago by Gaj.

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15 June 2016 at 3:47 pm #19124
Dr James
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- Guardian Angel
@fixhepc
The topic of drinking again post SVR has come up a few time so here are a few things to consider. First a reference text:

http://pubs.niaaa.nih.gov/publications/arh27-1/39-51.htm

And a graph:

This graph is a common phenomenon that speaks to “everything in moderation”.

1) For patients who don’t have Hep C moderate alcohol consumption REDUCES the relative risk of death compared to not drinking and the mimimum risk is seen at 20g (2 standard drinks) per day

2) Non-drinker’s and people who drink 7-8 standard drinks a day (ie a bottle of wine) have about the same all causes mortality risk.

3) Drinking at levels above this level is more risky than not drinking

4) Not shown on that graph but shown on this one (which comes from here: http://www.publications.parliament.uk/pa/cm201012/cmselect/cmsctech/1536/153606.htm)

a) Women can drink less than men before getting into the riskier than not drinking range
b) Some sources use 2.5 standard drinks for women and 4 standard drinks for men as the crossover point

So this is for someone whose liver has lived an easy life. If you are F0-F1 then post treatment you could reasonably assume you fit that profile.

On the other hand if you are F3-F4 your liver needs love and it would be sensible to be more moderate.

Binge drinking is bad. It’s a bit like the sun. A little bit of sun is healthy enough and gives you vitamin D and a tan. Too much sun on one day gives you sunburn and a substantial increase in melanoma risk because your body can’t deal with all the damage that happens in one hit.

YMMV
15 June 2016 at 4:01 pm #19127
beaches
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@beaches
Hi Doctor James
Does it matter what kind of alcohol you drink? Beer? White wine? Red wine? Spirits?

Genotype 1a
Diagnosed in 2004, had HCV for all my adult life. Until 2016!!!!
Harvoni treatment, started 19 March 2016
4 week results Bilirubin 12 down from 14 pre treatment,
Gamma 25 down from 52, ALT 19 down from 63, AST 19 down from 47,
VL <15 down from a lazy 6 million or so

EOT Results
Bilirubin 10, GGT 18, ALT 19, AST 21, VL UND

12 Weeks post EOT
Bilirubin 11, GGT 16, ALT 22, AST 20, VL UND
Cured baby
15 June 2016 at 4:05 pm #19129
GT2
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@gt2
Thanks for the advice Dr James

This is something that has been at the back of my mind for a while now.

Love the sun analogy.

1983: Hospitalised with Acute non-A, non-B Hepatitis after ICU blood transfusion 3mths earlier => HCV GT2
22/02/16: (pre-tmt) ALT 61, VL 2.48 IU/ml Hepascore 0.32 (F1/2), fatigue, brain fog, bloating (Treatment Na√Øve)
10/04/16: (Start tmt) Sofovir +DaclaHep (SOF + DCV) by Hetero Labs in India
09/05/16: ALT 34, VL: NOT Detected 🙂 , FBG 11.9
17/6/16 FBG 5.7; PPBG (@14.22) 6.9 (@ 20.45) 7.1; BP 124/72
🙂 (Accu-Chek Mobile & Omron Auto BP Monitor) 🙂
15 June 2016 at 4:19 pm #19131
Dr James
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@fixhepc
Hi Doctor James
Does it matter what kind of alcohol you drink? Beer? White wine? Red wine? Spirits?

These studies are for alcohol in the general case so mostly no, but…..

Wine, and probably red wine in particular contains “stuff” that seems to be beneficial. Some people say the “stuff” in wine is resvertrol and its impact on telomere shortening but the jury is still out on that. Here’s a link: http://www.resveratrolnews.com/the-end-of-aging-should-longevity-seekers-begin-taking-telomere-lengthening-pills/191/

See this article about the “French Paradox” to learn more….

http://winefolly.com/update/french-paradox-diet/

YMMV
15 June 2016 at 4:34 pm #19132
beaches
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@beaches
I was using Resveratrol before starting Tx and will probably go back on it.
The French and their unhealthy diet and skinniness…..

Genotype 1a
Diagnosed in 2004, had HCV for all my adult life. Until 2016!!!!
Harvoni treatment, started 19 March 2016
4 week results Bilirubin 12 down from 14 pre treatment,
Gamma 25 down from 52, ALT 19 down from 63, AST 19 down from 47,
VL <15 down from a lazy 6 million or so

EOT Results
Bilirubin 10, GGT 18, ALT 19, AST 21, VL UND

12 Weeks post EOT
Bilirubin 11, GGT 16, ALT 22, AST 20, VL UND
Cured baby
15 June 2016 at 4:39 pm #19133
Dr James
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- Guardian Angel
@fixhepc
The French and their unhealthy diet

….. which seems to do them no harm whatsoever …..

https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

YMMV
15 June 2016 at 4:52 pm #19135
sonix
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- Guardian Angel
@sonix
So looks like I need to stock up and drink some vino to stay healthy.

beaches wrote:

Hi Doctor James
Does it matter what kind of alcohol you drink? Beer? White wine? Red wine? Spirits?

I recommend Chateau Latour 2006 . Better get in quick!

M 61yo HCV+ ~ 30 yrs Gt1a F2 VL 223,000 ALT 54 AST 42 Tx start Sof/Dac 17Dec15.
SVR4 at 7Apr16 ALT 22 AST 22
SVR12 at 9Jun16 ALT 23 AST 25
Melbourne, Australia
15 June 2016 at 4:52 pm #19136
mgalbrai
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@mgalbrai
I’ll drink to that…. moderately.
I haven’t had a hangover in almost 4 years.
I don’t plan on having one in the future.
I’m not going to waste my “new lease” on life.
Coming up on my EOT 24. My GI says the test is my call. She’s comfortable with SVR 12 with the DAAs. I may just have a liver panel done.
m

Curehcvnow@gmail.com
http://forums.delphiforums.com/generichcvtx

G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24
15 June 2016 at 5:05 pm #19138
GT2
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@gt2
Well said mgalbrai

Everything in moderation.

1983: Hospitalised with Acute non-A, non-B Hepatitis after ICU blood transfusion 3mths earlier => HCV GT2
22/02/16: (pre-tmt) ALT 61, VL 2.48 IU/ml Hepascore 0.32 (F1/2), fatigue, brain fog, bloating (Treatment Na√Øve)
10/04/16: (Start tmt) Sofovir +DaclaHep (SOF + DCV) by Hetero Labs in India
09/05/16: ALT 34, VL: NOT Detected 🙂 , FBG 11.9
17/6/16 FBG 5.7; PPBG (@14.22) 6.9 (@ 20.45) 7.1; BP 124/72
🙂 (Accu-Chek Mobile & Omron Auto BP Monitor) 🙂
15 June 2016 at 5:06 pm #19139
mgalbrai
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- Guardian Angel
@mgalbrai
Including moderation…
M. Twain

Curehcvnow@gmail.com
http://forums.delphiforums.com/generichcvtx

G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24
16 June 2016 at 1:37 am #19150
rememberdecember
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- Acolyte
@rememberdecember
My (personal) choice is to not drink any alcohol at all. Why take the risk? And given I have a history of addiction, the risks are great and not just for my liver.

Dr F – in the studies you reference did they investigate whether the non-drinkers were in recovery? If they were then that could skew the potential health-benefits of moderate drinking (compared to abstainers). I appreciate that tannins in red wine are good for the heart and the general benefits of alcohol-induced relaxation no doubt help with stress etc. However, recovered alcoholics may have done harm to their health and may have other mental health problems like depression and anxiety underpinning their addictions, which in turn are known to increase morbidity.

If the studies compared life-time abstainers vs. moderate drinkers and lower morbidity was found in the latter then the results would be more valid. From vague memory, those studies do exist and I think they do show benefits for moderate drinking; but either way it’s a complex issue.

I stress this is a personal choice, and I form no judgement around people who choose to drink or addiction/alcoholism/mental health issues (from which I suffer).

Patrick

45 yo male; UK; HCV since 1996; G4; F2-3 (fibroscan score 9.1);
Null responder interferon/ribavirin 2008;
4/16 Harvoni 8 weeks; Pre-tx VL 2.1 million; week 4 VL 269; EOT UND; but…
6/16 Tx extended w/ generic sof/dac x 12 weeks due to concerns around my slow response to Harvoni. UND at end of 2nd round of treatment and EOT+4.
16 June 2016 at 2:43 am #19160
Gaj
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- Guardian Angel
@gaj
”James-Freeman-facebook” wrote:

The French and their unhealthy diet

….. which seems to do them no harm whatsoever …..

https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

Surprised to see how high on the ladder Aussies are!

…….must be all the Fosters Lager and meat pies.

G3a since ’78 – Dx ’12 – F4 (2xHCC)
24wk Tx – PEG/Riba/Dac 2013 relapsed
24wk Tx – Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx – 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 – 22/06/17 UND
SRV12 – 27/07/17 UND
SVR24 – 26/10/17 UND
16 June 2016 at 3:32 am #19163
beaches
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- Guardian Angel
@beaches
Gaj wrote:

”James-Freeman-facebook” wrote:

The French and their unhealthy diet

….. which seems to do them no harm whatsoever …..

https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

Surprised to see how high on the ladder Aussies are!

…….must be all the Fosters Lager and meat pies.

[/quote]

Last year I saw cans (or was it bottles) of Foster’s for sale in a grocery store in Thimphu, Bhutan.
Apparently Bhutanese beer us very good. An excellent excuse to go back.

Genotype 1a
Diagnosed in 2004, had HCV for all my adult life. Until 2016!!!!
Harvoni treatment, started 19 March 2016
4 week results Bilirubin 12 down from 14 pre treatment,
Gamma 25 down from 52, ALT 19 down from 63, AST 19 down from 47,
VL <15 down from a lazy 6 million or so

EOT Results
Bilirubin 10, GGT 18, ALT 19, AST 21, VL UND

12 Weeks post EOT
Bilirubin 11, GGT 16, ALT 22, AST 20, VL UND
Cured baby
16 June 2016 at 4:34 am #19168
Ariel
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@ariel
ALT <9 GGT 13-15 ish last bloods (SVR
Non drinker
Never will drink a drop again
I was never a real drinker in the Aussie archetypal way. (Mind you in the UK I laughed when they ask "will that be a large?")
Have had some beautiful wine during my age 35-40s after all I can stroll to a boutique winery from my farm. Probs just call it that mum chardy thing.
Don't feel like I'm missing anything and nowdays can't abide the smell of alcohol
No idea why the smell turns me off.
Maybe I just am overprotective of my body after all it's been through since diagnosis. Pretty sure that's me. I'm like that.
So.... To those who are raising the glass have a Bolinger for the mermaid here
16 June 2016 at 6:22 pm #19232
sonix
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@sonix
I have taken heed of this advice and now sipping on a pleasant 2011 Windy Peak Cabernet Merlot from the Yarra Valley. Mmmmm.

M 61yo HCV+ ~ 30 yrs Gt1a F2 VL 223,000 ALT 54 AST 42 Tx start Sof/Dac 17Dec15.
SVR4 at 7Apr16 ALT 22 AST 22
SVR12 at 9Jun16 ALT 23 AST 25
Melbourne, Australia
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