Drinking alcohol: Is it safe after hepatitis C cure?

Direct-acting antiviral medicines (DAAs) are very effective in treating hepatitis C, often curing the infection. Because these medicines are fairly new, research hasn’t clearly shown if drinking alcohol after successful treatment of hepatitis C with DAAs is safe. But to support liver health, it’s generally recommended not to drink alcohol if you have medical concerns that affect your liver. That includes a past hepatitis C infection.

Studies of DAAs show that some liver issues can last for years even after successful treatment of hepatitis C. And many studies clearly show that alcohol makes liver damage related to chronic hepatitis C worse. Drinking alcohol also raises the risk that liver damage could lead to other long-term health concerns.

Here are some of the study findings:

• Scarring in the liver. Chronic hepatitis C infection often causes scarring, also called fibrosis, in the liver. That scarring may last long after DAA treatment has cured the infection. Even if it doesn’t look like there is much scarring in the liver after DAA treatment, drinking alcohol can make that scarring worse. This is the same process that happens when alcohol causes liver damage in people who don’t have hepatitis C.
• Infection relapse. Although it’s rare, a hepatitis C infection can come back after DAA treatment. This is called a relapse. It typically happens during the first few months after the infection appears to go away. But sometimes a relapse happens much later. The exact cause of relapses isn’t known. Alcohol might play a role. The possibility that the infection may return is another reason not to drink.
• Liver cancer risk. Liver damage that happens due to hepatitis C raises the risk of liver cancer. Treatment of hepatitis C with DAAs lowers this risk somewhat. But it doesn’t reduce it to the same level as the liver cancer risk of someone who hasn’t had hepatitis C. Drinking alcohol has been linked to a higher risk of developing liver cancer after hepatitis C treatment.

If you are worried about how much alcohol you drink or would like help changing your drinking habits, talk with a healthcare professional. Treatment and resources are available to help.