For people with hepatitis C virus (HCV), as few as two drinks a day can significantly raise the risk of death, in particular from liver disease. Searching for clarity in the controversial topic of alcohol use as a risk factor for mortality in people with hep C, researchers assembled a cohort of 8,985 participants, 218 of whom were living with the virus, from the Third National Health and Nutrition Examination Survey (NHANES III) and questioned them about their alcohol intake. They published their findings in the journal Alimentary Pharmacology and Therapeutics.

With a median follow-up time of 163 months, participants with hep C had a mortality rate of 19 percent (54 deaths) for all causes, 1.66 percent (5 deaths) for cardiovascular death and 6.37 percent for liver-related death (11 deaths). In the control group, which had a median follow-up of 178 months, there was an all-cause mortality rate of 11.22 percent (1,266 deaths), 3.43 percent (410 deaths) for cardiovascular death and 0.15 percent (21 deaths) for liver-related death.

An unadjusted analysis showed that hepatitis C led to a nearly doubled risk of death for all causes, an almost 50-fold increase in risk for death due to liver disease, but no increase as a result of cardiovascular disease.

Those participants with hep C who drank excessively, defined as an average of two or more drinks each day, had a 5.12-fold increased risk of death for all causes and a 184-fold increase in death due to liver disease. By comparison, participants with hep C who drank not at all or less than two drinks per day on average had a 2.44-fold increased mortality risk for all causes and a 74-fold increased mortality risk from liver disease. In the control group, drinking two or more drinks each day was essentially irrelevant as a variable affecting mortality risk.
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