Koffie remt complicaties hepatitis C*
Regelmatig koffie drinken vertraagt de progressie van hepatitis-C-gerelateerde leverfibrose en -cirrose. Dit blijkt uit een
Amerikaanse studie, waarvan de resultaten zijn verschenen in Hepatology.
De Amerikaanse wetenschappers onderzochten 766 patiënten met chronische leveraandoeningen als gevolg van
hepatitis C, die niet reageerden op standaardbehandeling met antivirale middelen. Zij werden bijna vier jaar gevolgd en om de drie maanden gevraagd naar complicaties van de hepatitisinfectie.
Uit het onderzoek blijkt dat zij baat hebben bij een verhoogde koffie-inname. Patiënten die drie of meer kopjes koffie per dag drinken, hebben 53 procent minder risico op progressie van de leveraandoening dan niet-koffiedrinkers. Ze hebben minder last van steatose en portale hypertensie, en hebben een hogere albuminespiegel, aldus de onderzoekers. Consumptie van veel zwarte of groene thee heeft geen effect.
Overigens blijken de koffiedrinkers ook meer alcohol en sigaretten te gebruiken. Hiervoor hebben de onderzoekers gecorrigeerd. Zij zeggen dat er wel meer onderzoek nodig is om te achterhalen welke specifieke stoffen in koffie – en mogelijke andere factoren – verantwoordelijk zijn voor de verbetering.
De onderzoekers waarschuwen ten slotte dat het effect van koffie is onderzocht bij hepatitis-C-geïnfecteerden en niet
bij gezonde mensen.
Coffee intake is associated with lower rates of liver disease progression in chronic hepatitis
1Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD
2Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
3Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA
4Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
5New England Research Institutes, Watertown, MA
6Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, VA
7Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX
8Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI
9Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO
10Departments of Medicine and Molecular & Structural Biology and The Liver-Biliary-Pancreatic Center, University of Connecticut Health Center, Farmington, CT
11Division of Gastroenterology, University of California - Irvine, Irvine, CA
12Gastrointestinal Unit (Medical Services), Massachusetts General Hospital and the Department of Medicine, Harvard Medical School, Boston, MA
13Virology Division, Department of Laboratory Medicine, University of Washington, Seattle, WA
*Correspondence to Neal D. Freedman, Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, EPS/320, MSC 7232, Rockville, MD 20852
Current address: Carolinas Medical Center, Charlotte, NC
This is publication #38 from the HALT-C Trial Group.
Financial relationships of the authors with Hoffmann-La Roche, Inc., are as follows: K.L.L. is a consultant and receives research support; M.L.S. is a consultant, on the speaker's bureau, and receives research support; W.M.L. receives research support; A.S.L. is a consultant; A.M.D. is a consultant, on the speaker's bureau, and receives research support; H.L.B. receives research support; J.C.H. is on the speaker's bureau. Authors with no financial relationships related to this project are: N.D.F., J.E.E., M.G.G., T.M.C., C.C.A., R.S., J.L.D., and C.M.
The funding organizations had no role in the design and conduct of the study; the collection, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript.
fax: 301-496-6829
The HALT-C Trial was registered with clinicaltrials.gov (#NCT00006164).
Funded by:
National Institute of Diabetes and Digestive and Kidney Diseases
National Institute of Allergy and Infectious Diseases
National Cancer Institute
National Center for Minority Health and Health Disparities and by General Clinical Research Center
National Center for Research Resources
National Institutes of Health
Intramural Research Program of the National Cancer Institute
Hoffmann-La Roche, Inc. through a Cooperative Research and Development Agreement with the National Institutes of Health
Abstract
Higher coffee consumption has been associated inversely with the incidence of chronic liver disease in population studies. We examined the relationship of coffee consumption with liver disease progression in individuals with advanced hepatitis C-related liver disease. Baseline coffee and tea intake were assessed in 766 participants of the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) trial who had hepatitis C-related bridging fibrosis or cirrhosis on liver biopsy and failed to achieve a sustained virological response to peginterferon plus ribavirin treatment. Participants were followed for 3.8 years for clinical outcomes and, for those without cirrhosis, a 2-point increase in Ishak fibrosis score on protocol biopsies. At baseline, higher coffee consumption was associated with less severe steatosis on biopsy, lower serum aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, alpha-fetoprotein, insulin, and homeostatic model assessment (HOMA2) score, and higher albumin (P < 0.05 for all). Two hundred thirty patients had outcomes. Outcome rates declined with increasing coffee intake: 11.1/100 person-years for none, 12.1 for less than 1 cup/day, 8.2 for 1 to fewer than 3 cups/day, and 6.3 for 3 or more cups/day (P-trend = 0.0011). Relative risks (95% confidence intervals) were 1.11 (0.76-1.61) for less than 1 cup/day; 0.70 (0.48-1.02) for 1 to fewer than 3 cups/day; and 0.47 (0.27-0.85) for 3 or more cups/day (P-trend = 0.0003) versus not drinking. Risk estimates did not vary by treatment assignment or cirrhosis status at baseline. Tea intake was not associated with outcomes. Conclusion: In a large prospective study of participants with advanced hepatitis C-related liver disease, regular coffee consumption was associated with lower rates of disease
progression. HEPATOLOGY, (November
2009)
