BACKGROUND & AIMS: High level coffee consumption has been associated with reduced progression of pre-existing liver diseases and lower risk of hepatocellular carcinoma. However, its relationship with therapy for Hepatitis C virus (HCV) infection has not been evaluated.
METHODS: Patients (n=885) from the lead-in phase of the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) trial recorded coffee intake before re-treatment with peginterferon alfa-2a (180 μg/wk) and ribavirin (1000-1200 mg/day). We assessed patients for early virologic response (EVR, 2 log(10) reduction in level of HCV RNA at week 12; n=466) and undetectable HCV RNA at week 20 (W20VR; n=320), week 48 (end of treatment, EOT; n=284), and week 72 (sustained virologic response, SVR; n=157).
RESULTS: The median log(10) drop from baseline to week 20 was 2.0 (interquartile range: 0.6-3.9) among non-drinkers and 4.0 (2.1-4.7) among patients that drank ≥3 cup/day of coffee (P-trend <0.0001). In unadjusted models, the odds ratios (OR) and 95% confidence intervals (CI) for drinking ≥3 cups/day vs non-drinking were 3.2 (1.9-5.3) for EVR, 3.1 (1.8-5.1) for W20VR, 3.5 (2.0-5.9) for EOT, and 2.7 (1.4-5.3) for SVR (P-trend<0.0001 for all). After adjustment for age, race/ethnicity, sex, alcohol, cirrhosis, ratio of aspartate aminotransferase:alanine aminotransferase, the IL28B polymorphism rs12979860, dose reduction of peginterferon, and other covariates, the OR (95% CI) for EVR was 2.0 (1.1-3.6; P-trend = 0.004); for W20VR was 2.1 (1.1-3.9; p-trend=0.005); for EOT was 2.4 (1.3-4.6; P-trend=0.001), and for SVR was 1.8 (0.8-3.9; P-trend=0.034).
CONCLUSION: High-level consumption of coffee (more than 3 cups per day) is an independent predictor of improved virologic response to peginterferon plus ribavirin in patients with Hepatitis C.