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Research Summary

Does Alcohol Use Increase Hepatitis C Virus Replication?

Among patients with hepatitis C, those who drink heavily have more severe liver disease than those who abstain. However, the mechanism by which alcohol use worsens liver disease among these patients is not known. To examine one possible mechanism, researchers performed a meta-analysis of studies that assessed the cross-sectional association between alcohol use and hepatitis C virus replication.

  • Three of 9 studies showed significantly higher hepatitis C viral levels in heavy drinkers (defined variably) than in nondrinkers. However, when data from all 9 studies were combined, this difference was no longer significant.
  • Hepatitis C viral levels did not increase as alcohol use increased, according to combined data from 4 studies that examined nondrinkers, moderate drinkers, and heavy drinkers.


This meta-analysis did not find a consistent association between alcohol use and hepatitis C virus replication. The conclusions from this study are limited due to its small sample size, differences in how studies defined heavy drinking, the cross-sectional analyses, and lack of control for the quality of the studies, duration of alcohol use, and antiviral treatment. However, while the mechanism of liver damage from co-occurring hepatitis C and heavy alcohol use remains uncertain, the recommendation for patients with hepatitis C to abstain or minimize alcohol use remains unchanged.

Kevin L. Kraemer, MD, MSc


Anand BS, Thornby J. Alcohol has no effect on hepatitis C virus replication: a meta-analysis. Gut. 2005;54(10):1468–1472.