Coffee has hepatoprotective benefits in Brazilian patients with chronic hepatitis C even in lower daily consumption than in American and European populations

Abstract

The potential role of coffee as a hepatoprotective substance for chronic liver diseases has been widely discussed. Our main aim was to evaluate the effect of coffee intake regarding clinical, biochemical tests and liver biopsy data in treatment naïve patients with chronic hepatitis C. One hundred and thirty-six patients with chronic hepatitis C, diagnosed through liver biopsy, or by means of clinical, ultrasound or endoscopic signs of cirrhosis, were assessed by determination of biochemical tests, metabolic and morphological alterations. Food frequency was scrutinized by using a structured questionnaire. Coffee intake represented more than 90% of the total daily caffeine, and the 75th percentile was 4-Brazilian coffee-cup/day (≥ 255 mL/day or ≥ 123 mg caffeine/day). According to caffeine intake, patients were divided into two groups (< or ≥ 123 mg caffeine/day). Patients with higher ingestion of caffeine had lower serum levels of aspartate aminotransferase (× upper limit of normal) (1.8 ± 1.5 vs 2.3 ± 1.5, p=0.04), lower frequencies of advanced (F3, F4) fibrosis (23.5% vs 54.5%, p<0.001) and of histological activity grade (A3, A4) observed in liver biopsies (13.8% vs 36.9%, p<0.001). By multivariate logistic regression, fibrosis was independently associated with caffeine intake (OR- 0.16; 95%CI - 0.03-0.80; p=0.026), γ-glutamil transferase serum levels and morphological activity. But only fibrosis was associated with histological activity. In conclusion caffeine consumption greater than 123 mg/day was associated with reduced hepatic fibrosis. In addition, this study supports the assumption that coffee intake has hepatoprotective benefits for Brazilian patients with chronic hepatitis C, even in lower doses than that of American and European population intake.

Effects of caffeine consumption in patients with chronic hepatitis C: A systematic review and meta-analysis

“…Thirty articles underwent full-length review, of which 19 articles were excluded because they were not related to hepatitis C (12 articles), did not have controls or comparison of high versus low caffeine intake (5 articles), was a letter to the editor (1 article), or was an abstract (1 article). Eleven studies were included in the qualitative analysis [16][17][18][19][20][21][22][23][24][25][26], and five studies were included in the meta-analysis [17,[21][22][23][24]. Fig.…”

“…Five observational studies (all cross-sectional studies) involving 1507 participants were included in the data Modi et al [23] Costentin et al [17] Machado et al [22] Khalaf et al [21] Oliveira et al [ analysis for the risk of advanced hepatic fibrosis [17,[21][22][23][24]. The pooled OR of advanced hepatic fibrosis in patients who had higher caffeine intake was 0.39 (95% CI: 0.21-0.72) (Fig.…”

“…The liver fibrosis staging scale used to quantify the degree of liver fibrosis varied among studies. The METAVIR scoring system was used in four studies [17,21,22,24], and the Ishak score was used in one study [23]. Hepatic fibrosis was evaluated by liver biopsy in four studies [17,[22][23][24], and by the FibroSURE (BioPredictive, Paris, France) test in one study [21].…”

“…Six studies reported the effect of caffeine consumption on liver enzymes (one randomized controlled trial (RCT) [16], three prospective studies [19,20,25], and two crosssectional studies [17,22]); the findings are summarized in Table 2. Some studies noted a beneficial effect of caffeine on liver enzymes.…”

25 years of Hepatitis C

“…It has long been aware of the beneficial effects of coffee on serum liver enzymes and the alcoholic liver disease, but since 2009 several studies have shown that caffeine intake, especially in the form of coffee, has a protective effect on the development of hepatitis C virus (12,14,21,22) . In our previously published study (21) , we observed a reduction in liver fibrosis in patients taking higher doses of caffeine in univariate and multivariate analysis when compared to patients with lower daily intake of caffeine, but did not observe a relationship between caffeine with inflammatory activity in liver biopsy. We drew attention fact that the amount of caffeine necessary to reduce the degree of fibrosis was significantly lower than in English literature (125 mg or only 4 Brazilian cups of coffee versus 250 mg or 308 mg daily).…”