Updated on February 6, 2024
6 min read

The Connection Between Hep C and Alcohol: Risks and Safety Precautions

Hep C and Alcohol

Hepatitis C is a liver inflammation caused by the hepatitis C virus. Unlike hepatitis A and hepatitis B, no current preventative vaccine is available for the general population. Fortunately, treatments are available.

Acute hepatitis C

This type of hepatitis C occurs within six months of exposure to the virus. People may report mild symptoms like lack of appetite or jaundice (yellow skin or eyes) lasting a few weeks. 

Chronic hepatitis C

Chronic hepatitis C develops in more than half of those infected with acute hepatitis C. Chronic HCV infection can cause:

  • Liver injury
  • Liver failure
  • Cirrhosis
  • Liver cancer
  • Death

Can Drinking Alcohol Aggravate Hep C?

Alcohol use can worsen a hepatitis C virus infection. However, it will never cause the medical condition itself.

When diagnosed with HCV, doctors typically advise people to stop drinking to prevent further damage to liver cells and ensure effective treatment. Ignoring this can impede recovery and hinder progress toward a healthier future.

How Much Alcohol is Safe?

There’s no designated "safe" alcohol level for people with hep C. It’s best to avoid alcohol altogether.

A person with hepatitis C who continues to drink alcohol will soon discover that the damage will escalate rapidly. The disease will accelerate and pose a greater danger to their health.

Hepatitis C Prevalence

According to the CDC, over 2 million people in the U.S. have hepatitis C as of 2020. That equates to approximately 1% of the American adult population.

Nearly 40% of Americans with hepatitis C are unaware they have the virus, preventing them from receiving life-saving treatment. Additionally, new infections have increased almost fourfold in the past decade.

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How Hepatitis C and Alcohol Increase the Risk of Liver Disease

Those with hepatitis C are at a higher risk of developing alcoholic hepatitis. When left untreated, HCV places the liver under great stress. Consuming alcohol can further cause inflammation of the organ.

Alcohol can also affect the body’s immune system. This makes it difficult for the viral load to reduce. 

Alcohol + Cirrhosis

The combination of hepatitis C and alcohol increases the risk of cirrhosis. Chronic hepatitis C infection can increase the risk of developing hepatocellular cancer.

The two types of cirrhosis are:

  • Compensated cirrhosis: A stage of liver disease where a person doesn't experience any noticeable symptoms. 
  • Decompensated cirrhosis: The onset of symptoms and impairment of liver function due to advanced progression. 

Heavy drinkers with chronic hep C infection are most likely to develop cirrhosis. However, those diagnosed with hep C who don’t drink alcohol have a lower risk of developing severe liver disease.

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Other Risk Factors of Drinking with Hepatitis C

Apart from alcohol consumption and HCV, other risk factors contribute to alcoholic hepatitis.

These examples include:

  • Sex: Alcoholic hepatitis poses a higher risk to women than to men. Since the primary liver enzyme breaking down alcohol isn't as common in women as in men, women face more difficulty metabolizing the substance.
  • Obesity: People who are overweight and heavy drinkers face a higher likelihood of alcoholic hepatitis and cirrhosis.  
  • Race and Ethnicity: Blacks and Hispanics may have an increased risk of developing the disease.
  • Binge drinking: The risk increases for men who consume five or more drinks within two hours and women who consume four or more within the same time frame. 
  • Malnutrition: Heavy drinking can be linked with malnourishment. This is typically due to poor eating habits or the body’s inability to absorb nutrients. Alcohol and its byproducts can prevent nutrient absorption and damage liver cells. 

Treatment for Hepatitis C

Doctors prescribe antiviral therapy and eight to 24 weeks of oral medication (pills) to treat chronic liver disease. The duration of antiviral therapy can vary depending on the genotype of the hepatitis C virus and the person’s response to the treatment.

Treatment programs are effective. They cure more than 95% of cases with minimal side effects.8 

Alcohol Abstinence in Hepatitis C Treatment

It’s unclear how long a person must abstain from alcohol use before the adverse effects of alcohol reverse. It’s also worth noting that alcohol consumption can accelerate the disease progression of hepatitis C, resulting in permanent liver scarring. 

Because of this, quitting alcohol use should be part of a treatment plan for people suffering from chronic HCV. This primarily refers to those with compensated or decompensated cirrhosis. 

Illicit Drug Use and Peginterferon

People should avoid any illicit drug use during treatment. Additionally, those who require peginterferon should abstain from alcohol for at least six months before beginning treatment. 

Peginterferon is a medicine used to treat hepatitis C and B. The drug is sold under the brand name Pegasys (among others). When peginterferon is combined with alcohol, it can increase the risk of liver damage and worsen side effects. Therefore, it’s strongly advised to avoid alcohol consumption while undergoing peginterferon treatment for hepatitis C.

Can I Drink Alcohol After Treatment?

Healthcare professionals recommend not drinking alcohol after treatment. Even if cured of the disease, there may be liver scarring caused by the viral infection. 

Alcohol may increase that scarring. Similarly, alcohol use after hepatitis C treatment has been associated with the risk of liver cancer.

If you believe you or a loved one suffers from alcohol abuse, seek professional medical help immediately. Your healthcare specialist can provide a treatment plan to guide your recovery path.

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Effects of Excessive Alcohol Consumption

Drinking alcohol in large quantities can cause extensive and chronic liver inflammation. This can potentially lead to alcoholic liver disease, which has three types:

  • Fatty liver disease
  • Alcoholic hepatitis 
  • Alcoholic cirrhosis 

Fatty liver disease and alcoholic hepatitis are reversible. Alcoholic cirrhosis, however, is permanent and can be fatal. 

Alcohol use can worsen medical conditions like viral hepatitis responsible for the hepatitis C virus (HCV). When mixed, hepatitis C and alcohol use may also contribute to liver fibrosis (scarring) and other health risks. 

What is Alcoholic Hepatitis?

Alcoholic hepatitis refers to inflammation of the liver due to alcohol consumption. The disease tends to occur in people who drink heavily over an extended period. However, there’s still a risk for those who consume moderate alcohol.

The common symptoms of alcoholic hepatitis include:

  • Fatigue and weakness 
  • Jaundice 
  • Lack of appetite
  • Nausea and vomiting
  • Low-grade fever 
  • Tenderness in the abdomen 

In more severe cases, symptoms may include:

  • Collection of fluid in the abdomen 
  • Changes in behavior or confusion 
  • Kidney failure
  • Permanent scarring of the liver (cirrhosis)

Alcohol Metabolism in the Liver

The liver is responsible for alcohol metabolism. It converts ethanol in alcoholic drinks into acetaldehyde using enzymes called alcohol dehydrogenase (ADH).

Regardless of the amount in the body, acetaldehyde can be toxic. That’s why the liver breaks it down further into non-toxic acetate.

Most of the acetate then circulates through the bloodstream to enter other energy- or molecule-producing metabolic cycles. When alcohol consumption is high, the liver cannot quickly break down the substance, resulting in a hangover. 

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Updated on February 6, 2024
9 sources cited
Updated on February 6, 2024
  1. Alcoholic Hepatitis.” Mayo Foundation for Medical Education and Research, 2018.
  2. Hepatitis C Questions and Answers for the Public.” Centers for Disease Control and Prevention, 2020.
  3. Lieber, CS. “Alcohol and Hepatitis C.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, n.d.
  4. Mahler, JJ. "Exploring Alcohol’s Effects on Liver Function." National Institute on Alcohol Abuse and Alcoholism, 1997.
  5. Rizza, Stacey A. “Drinking after Hepatitis C Cure: Is It Safe?” Mayo Foundation for Medical Education and Research, 2019.
  6. "What Is Viral Hepatitis?" National Institute of Diabetes and Digestive and Kidney Diseases, May 2017.
  7. Ryerson et al. “Vital Signs: Newly Reported Acute and Chronic Hepatitis C Cases ― United States, 2009–2018.” Centers for Disease Control and Prevention, 2020.
  8. Hepatitis C.” World Health Organization, 2021.
  9. Hepatitis C: By the Numbers.” Centers for Disease Control and Prevention, 2023.

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