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  DDW - Digestive Disease Week 2014
May 4, 2014, Chicago
Illinois, United States
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Intake of Coffee and Caffeine are Associated with Decreased Risk of Hepatitis C-related Hepatic Fibrosis
  Reported by Jules Levin
DDW 2014 May 4-6 Chicago, ILL
Khalaf N, White D, KanwalF, Ramsey D, Mittal S, TabasiS, KuzniarekJ, HashemB El-Serag
Houston VA Medical Center and Baylor College of Medicine, Houston, Texas


Program abstract:
Beverage Intake and the Risk of Advanced Fibrosis in HCV: Coffee, Tea, or Sodas?

Hashem El-Serag, Jill Kuzniarek, David J. Ramsey, Shahriar Tavakoli Tabasi, Donna L.
White, Fasiha Kanwal
Background: Coffee drinking has been associated with reduced risk of cirrhosis and hepatocellular carcinoma. The reasons for these observations are unclear, although caffeine has been proposed by experimental studies to have antifibrotic and antineoplastic effects. There are only a few studies that examined coffee intake as well as caffeine intake in different beverages among patients with a uniform risk factor for liver disease (i.e., HCV).
Methods: We conducted a cross-sectional study of HCV-infected veterans. The main exposure variable was daily coffee intake calculated from a self-reported detailed questionnaire and the main outcome variable was FibroSURE-ActiTest determined hepatic fibrosis (F0-F3=mild vs. F3/F4-F4= advanced). We also evaluated self-reported coffee drinking during several age periods (40s, 50s, and 60s), and other beverages including decaffeinated coffee, caffeinated and decaffeinated tea, and caffeinated and decaffeinated carbonated sodas. We examined these associations in logistic regression analyses adjusting for demographic, clinical, and other dietary variables.
Results Among 952 HCV+ patients (97.6% men), 355 (37.3%) had advanced fibrosis. The mean (SD) daily intake of coffee (caffeinated, decaffeinated), tea, and carbonated beverages in cases vs. controls are shown in Table 1. Overall coffee intake but not decaffeinated coffee was inversely associated with advanced fibrosis. Coffee intake in all age group was higher in those with mild fibrosis compared with advanced fibrosis although none of the comparisons were significant because of the smaller sample sizes. There was a trend toward higher soda intake (but not decaffeinated sodas) in patients with mild fibrosis. Tea drinking was not significantly associated with the degree of hepatic fibrosis. In multivariate analysis adjusting for age, diabetes, alcohol use, overweight category, and soda consumption, the inverse association between the number of daily cups of coffee and advanced fibrosis persisted (adjusted OR 0.693, 95% CI 0.503-0.956, for each additional daily cup).
Conclusions Coffee drinking is possibly protective against advanced hepatic fibrosis in HCV+ patients. The findings are suggestive of an important role for caffeine in explaining this observation.
Table 1: Comparison of HCV+ patients with and without advanced fibrosis