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Coffee and Caffeine Are Associated With Decreased Risk of Advanced Hepatic Fibrosis Among Patients With Hepatitis C

  • Natalia Khalaf
    Affiliations
    Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas

    Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
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  • Donna White
    Affiliations
    Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas

    Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
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  • Fasiha Kanwal
    Affiliations
    Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas

    Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
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  • David Ramsey
    Affiliations
    Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas

    Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
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  • Sahil Mittal
    Affiliations
    Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas

    Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
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  • Shahriar Tavakoli-Tabasi
    Affiliations
    Section of Infectious Diseases, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
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  • Jill Kuzniarek
    Affiliations
    Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
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  • Hashem B. El-Serag
    Correspondence
    Reprint requests Address requests for reprints to: Hashem B. El-Serag, MD, MPH, Michael E. DeBakey VA Medical Center, 2002 Holcombe Boulevard (MS152), Houston, Texas 77030. fax: (713) 748-7359.
    Affiliations
    Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas

    Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
    Search for articles by this author
Published:March 14, 2015DOI:https://doi.org/10.1016/j.cgh.2015.01.030

      Background & Aims

      Coffee or caffeine has been proposed to protect against hepatic fibrosis, but few data are available on their effects in patients with chronic hepatitis C virus (HCV) infection.

      Methods

      We conducted a cross-sectional study of veterans with chronic HCV infection to evaluate the association between daily intake of caffeinated and decaffeinated coffee, tea, and soda, and level of hepatic fibrosis, based on the FibroSURE test (BioPredictive, Paris, France) (F0–F3, mild [controls] vs F3/F4–F4, advanced). Models were adjusted for multiple potential confounders including age, alcohol abuse, and obesity.

      Results

      Among 910 patients with chronic HCV infection, 98% were male and 38% had advanced hepatic fibrosis. Daily intake of caffeinated coffee was higher among controls than patients with advanced fibrosis (1.37 vs 1.05 cups/d; P = .038). In contrast, daily intake of caffeinated tea (0.61 vs 0.56 cups/d; P = .651) or soda (1.14 vs 0.95 cans/d; P = .106) did not differ between the groups. A higher percentage of controls (66.0%) than patients with advanced fibrosis (57.9%) consumed 100 mg or more of caffeine daily from all sources (P = .014); controls also received a larger proportion of their caffeine from coffee (50.2% vs 43.0%; P = .035). Hepatoprotective effects of an average daily intake of 100 mg or more of caffeine (adjusted odds ratio, 0.71; 95% confidence interval, 0.53–0.95; P = .020) and 1 cup or more of caffeinated tea by non–coffee drinkers (adjusted odds ratio, 0.56; 95% confidence interval, 0.34–0.94; P = .028) persisted after adjustment for confounders, including insulin resistance.

      Conclusions

      A modest daily caffeine intake (as little as 100 mg) may protect against advanced hepatic fibrosis in men with chronic HCV infection. Additional research is needed to confirm these findings in women and in people with other chronic liver diseases.

      Keywords

      Abbreviations used in this paper:

      BMI (body mass index), CI (confidence interval), HALT-C (Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis), HCC (hepatocellular carcinoma), HCV (hepatitis C virus), HOMA-IR (homeostasis model assessment–estimated insulin resistance), IDU (injection drug use), MEDVAMC (Michael E. DeBakey Veterans Affairs Medical Center), MELD (Model for End-Stage Liver Disease), OR (odds ratio)
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