Why is Alcohol Harmful for People with Hepatitis?
Avoiding alcohol is the most important lifestyle change you
should make after a viral hepatitis diagnosis. Why? Because drinking
alcohol accelerates the rate of progression of the liver disease.
When the alcohol gets into the body, 95% of it will be metabolized in the
liver. Inside the liver cells, alcohol turns to acetaldehyde, which is
even more toxic to the liver than the original form of alcohol. The
alcohol and its metabolite intoxication cause the liver to inflame and
long-term drinking causes the inflammation to be persistent. This onset of
inflammation leads to an over-production of free radicals that can further
damage liver cells and impair their functions.
Alcohol also reduces the production of antioxidants, which
are the body's natural defenses against free radicals. When these harmful
effects are added to the strain of the liver inflammation caused by the
HBV or HCV infection, the progression of fibrosis can accelerate
On top of exacerbating inflammation, Acetaldehyde can also
cause fibrosis directly. One of the mechanisms that alcohol promotes
disease progression directly is by increasing the amount of certain
cytokines such as TGFb1 (transforming growth factor-beta 1), PDGF
(platelet delivered growth factor), and PAI (Plasminogen activator
inhibitor). This increase activates the stellate cells of the liver and
causes the cells to loss their vitamin A content, which then begins to
produce scar tissue. (See previous column articles about fibrosis.) The
activated stellate cells can also constrict blood vessels, reducing the
blood infusion to the liver cells and decreasing the oxygen and nutrition
supply of the liver cells.
As you can see, alcohol can promote fibrosis in more ways
than one and can increase the chances of progression to cirrhosis.
Although many hepatitis patients try to "negotiate" with their
doctors about alcohol use in limited amounts, it is my belief that they
should avoid it altogether. Since there are no studies that have
determined what is a “safe” amount of alcohol to drink for a patient
with chronic liver diseases, the safest route is to not drink.
Thus, if you have hepatitis B or C, I strongly recommend that you
eliminate alcohol from your life. You will live better and longer!