Santa Fe 2011 Santa Fe, USA 2011
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Abstract #81  -  Coffee consumption and side-effects relief during HCV treatment (ANRS CO13 HEPAVIH): a possible research hypothesis
  Presenting Author:   Dr Bruno Spire - INSERM
  Additional Authors:  Dr. M.Patrizia Carrieri, Mr. Julien Cohen, Dr. Dominique Salmon, Dr. François Dabis, Dr. Maria Winnock,  
While the positive effect of elevated coffee consumption on liver fibrosis and liver cancer has already been demonstrated, recent results show that elevated coffee consumption is associated with sustained virological response in patients receiving HCV treatment. However, it is unknown whether elevated coffee consumption can relieve the perceived HCV-treatment toxicity burden, one of the major causes of HCV treatment discontinuity. Therefore, in this study, we assessed the impact of coffee consumption on perceived toxicity, measured by self-reported side-effects.
  Method / Issue:
Patients enrolled in the HEPAVIH ANRS CO13 cohort of HIV-HCV-infected individuals receiving antiretroviral therapy (ART),who started peginterferon alfa-2a and ribavirin during follow-up with complete data about coffee consumption and self-reported discomforting side-effects during HCV treatment were selected (N=106, 138 visits). A 5-category variable measured coffee consumption on a five-point scale: “no consumption”, “occasional consumption”, “one cup per day”, “two cups per day”, “3 or more cups of coffee per day”. Self-reported side-effects included 30 treatment-related symptoms over the previous four weeks and the discomfort they caused. A logistic regression model based on Generalized Estimating Equations was used to study the relationship between caffeine consumption and presence of discomforting side-effects.
  Results / Comments:
Among the 106 selected patients, 71% were men, median [IQR] age was 44 [41-46] years and most of the participants (80%) were HIV-infected through injecting drug use. At enrollment, 86% of the patients had undetectable plasma HIV RNA, 52% presented with severe fibrosis (F3-4) and 13% had a CD4 count <200/mm3. The median [IQR] number of self-reported side-effects causing discomfort was 3 [0-8] and 31% did not report any discomforting side-effect. Patients drinking ≥3 cups of coffee per day were less likely to report discomforting side-effects than non-drinkers (OR[95%CI]=0.19[0.05-0.78], p=0.02). The association between drinking 3 or more cups and self-reported side-effects remained significant (AOR[95%CI]= 0.18[0.03-0.96], p=0.04) even after adjustment for gender, age and history of opioid use, which are known correlates of reporting a higher number of discomforting side-effects. In addition, the likelihood of reporting discomforting side-effects during HCV treatment linearly decreased across the five categories of coffee consumption (OR[95%CI]=0.67[0.49-0.90], p=0.008) and remained significant after adjustment for age, gender and history of opioid use (AOR[95%CI]=0.64[0.45-0.91], p=0.01).
Several performance benefits are attributed to caffeine including fatigue reduction and improvements in mental concentration and alertness which are often impaired in patients receiving HCV treatment. These results, obtained in an observational cohort in a population affected by a double viral infection clearly underline the multiple benefits which caffeine may have for HCV-infected receiving PEG-IFN + Ribavirine and suggest an easy and inexpensive approach for side-effects relief and potentially assure continuity of treatment.
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