Coffee Halves Risk of Dying in HCV/HIV Coinfected Patients

Patients coinfected with HIV and HCV who drink at least 3 cups of coffee a day can cut their risk of dying in half, according to a new study.

This study is the first to investigate the relationship between coffee consumption and the risk of all-cause mortality in HIV-HCV coinfected patients.

“This is a very exciting time for HCV research as a cure that can eradicate the virus is now available for all patients. However, even when cured of HCV, patients coinfected with HIV have a higher risk of death with respect to the general population, due to an accelerated aging process that may result from cancer, complications related to diabetes and to liver disease, and from cardiovascular events,” said co-author Dominique Salmon-Céron, MD, PhD, of the Service des Maladies Infectieuses et Tropicales, Hôpital Cochin, and Université Paris Descartes, Paris, France.

Coinfected patients are at risk of end-stage liver disease and greater risk of cardiovascular diseases and cancer. HIV infection accelerates the progression of chronic HCV to fibrosis and development of cirrhosis and end-stage liver disease.

Coffee is known to have anti-inflammatory and hepato-protective properties. In the general population, drinking 3 or more cups of coffee a day has been associated with a 14% reduction in the risk of all-cause mortality. Polyphenols contained in coffee may play a protective role in liver injury through a reduced risk of insulin resistance and reduced inflammation.

The researchers published their results September 12, 2017 in Journal of Hepatology.

The French researchers analyzed data from a 5-year follow-up of 1,028 HIV-HCV coinfected patients enrolled in the French national ANRS CO13-HEPAVIH cohort. This ongoing French nationwide prospective cohort of HIV-HCV coinfected patients collects both medical and psychosocial/behavioral data over time via annual self-administered questionnaires.

At enrollment, about one-quarter of patients reported drinking at least 3 cups of coffee daily. Over the 5 years, 77 deaths occurred; the leading causes of death were HCV-related diseases (43%), cancers unrelated to AIDS/HCV (12%), and AIDS (10%).
Elevated coffee consumption at baseline was associated with a 50% reduced risk of all-cause mortality, after adjustment for gender and psychosocial, behavioral and clinical time-varying factors. Mortality risk was 80% lower in those who were cleared of HCV with treatment.

The study suggests that HCV treatment must be complemented by behavioral changes to improve health and survival in HIV-infected patients, regardless of whether they clear HCV, the researchers stated.

“I think we need to better monitor coffee consumption, together with other behaviors, such as alcohol use, smoking, physical activity, and to propose interventions to our patients which facilitate healthy behaviors even after HCV clearance. We also suggest that those patients who cannot tolerate a high intake of caffeine should consider drinking a few cups of decaffeinated coffee a day,” said Salmon-Céron.

She added: “Accordingly, I believe that the benefits of coffee extracts and supplementing dietary intake with other anti-inflammatory compounds need to be evaluated in HIV-HCV patients.”