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Coffee Helps Reduce Side Effects in HIV/HCV Coinfected People during Interferon-based Therapy

HIV/HCV coinfected people who drink at least 3 cups of coffee daily were less likely to experienced adverse events related to interferon-based therapy for hepatitis C, according to a French study presented at the 10th AIDS Impact Conference last month in Santa Fe. However, whether coffee somehow directly relieves side effects remains unknown.

Several studies have shown that coffee appears to have a beneficial effect on liver inflammation and fibrosis among people with hepatitis C, and it has also been linked to higher rates of sustained response to interferon-based treatment.

Since side effects related to interferon and ribavirin -- which can include depression, fatigue, flu-like symptoms, and red and white blood cell deficiencies -- are a common reason for treatment discontinuation, researchers assessed the effect of coffee consumption on self-reported side-effects among HIV/HCV coinfected individuals.

The analysis included 106 participants in the HEPAVIH ANRS CO13 cohort of coinfected patients on combination antiretroviral therapy. Most (71%) were men, the median age was 44 years, and 80% had a history of injection drug use. Most (86%) had undetectable HIV viral load and a similar proportion had CD4 T-cell counts above 200 cells/mm³. About half had severe fibrosis or cirrhosis (stage F3-F4) at baseline.

Participants started hepatitis C treatment consisting of pegylated interferon alfa-2a (Pegasys) plus ribavirin. During a total of 138 visits, researchers collected data about coffee consumption and self-reported uncomfortable or "discomforting" side effects during hepatitis C treatment.

Coffee consumption was classified using a 5-category scale: no consumption, occasional consumption, 1 cup per day, 2 cups per day, and 3 or more cups per day. Patients were asked about 30 treatment-related symptoms experienced during the prior 4 weeks and the degree of discomfort or distress they caused.

Results

• The median number of reported discomfort-causing side effects was 3.
• One-third of participants did not report any discomforting side effects.
• People who drank 3 or more cups of coffee per day were significantly less likely to report discomforting side effects than those who did not drink coffee (odds ratio [OR] 0.19, or about 80% less likely).
• The association between drinking 3 or more cups of coffee daily and side effects remained significant after adjusting for sex, age, and history of opioid use, which are known factors associated with self-reported adverse events (adjusted OR 0.18).
• The likelihood of self-reported discomforting side effects during treatment decreased linearly over the 5 coffee consumption categories, decreasing by about 30% at each level.
• Again, this trend remained significant after adjusting for sex, age, and opioid use.

"These results, obtained in an observational cohort in a population affected by a double viral infection clearly underline the multiple benefits which caffeine may have for HCV-infected receiving [pegylated interferon/ribavirin] and suggest an easy and inexpensive approach for side effects relief and potentially assure continuity of treatment," the researchers concluded.

They suggested that the link may be related to "performance benefits" attributed to caffeine, including reduced fatigue and improved mental concentration and alertness, which may be impaired in people receiving hepatitis C treatment.

However, the investigators did not differentiate in their report between consumption of caffeinated vs decaffeinated coffee. Other studies have seen liver health benefits associated with only coffee and not other caffeinated beverages such as tea, suggesting that other components of coffee -- perhaps atioxidants -- may contribute to its observed benefits.

10/7/11

Reference

B Spire, MP Carrieri, J Cohen, et al. Coffee consumption and side-effects relief during HCV treatment (ANRS CO13 HEPAVIH): a possible research hypothesis. 10th AIDS Impact Conference. Santa Fe, NM, September 12-15, 2011. Abstract 81.