Harvoni and Alcohol

[DisabledHepcat]

Nothing suggests Harvoni is in-effective with Alcohol intake so why all the irresponsible decisions created by medicaid and other insurance companies? Alcoholics are people too !

You should avoid alcoholic beverages, not specifically because you are taking Harvoni, but because no amount of alcohol is considered safe for those with hepatitis C or other liver diseases. Any amount of alcohol can further damage the liver.

So why the discrimination? Tylenol destroys the liver also !

[Sixgolds]

I was told no Products with Tylenol.  IF it's an absolute necessity then wait at least 3 hours before and after Harvoni dose.  As for alcohol, my doc says none but I do drink a liquore at least once a week, on average.  Been on Harvoni since Jan 2.... Liver enzymes within normal limits first time in 25 years!!  Still awaiting viral load results, was 1,500,000 or so before I began.

[Tpropane]

Your insurance can deny your treatment based on alcohol or drug use.

[Lynn K]

With cirrhosis bleeding is more of a concern so patients with cirrhosis in general are advised to not take anything other than Tylenol but to make sure you limit the dose to no more than 2000 Mg/day.

But in general to try to keep even this one allowed pain med to a minimum for example don't take 2000 Mg every day.

Sixgolds

My suggestion is stop drinking. I was diagnosed with cirrhosis in Jan 2008 from hep c you really don't want to ever hear your doctor tell you you have cirrhosis trust me on that.

[lporterrn]

Disabled Hep Cat - Although I don't drink and I am concerned about alcohol use and liver disease, I am deeply disturbed by this trend in insurance. It may be left over from the old interferon days when the decision made sense. This current trend is not medically-based and I think it is a way to keep cost down. Denying treatment to people who won't fight back may be a business decision. It fries me. 

[MEG]

I agree with Lynn about the alcohol. As someone who love(d) her red wine at the end of a work day, I quit the very day I got the hepC diagnosis 20 years ago. A sip of champagne at weddings and that's it.

Alcohol while on Harvoni may/probably will inhibit your chance at a full recovery. As others say, it's like pouring gasoline into a fire...

For anyone drinking alcohol I'd ask myself: What is more important to me? Being free of this virus that will eventually shut down my liver or the short-term high from alcohol.?

Also, I think that by drinking alcohol and perhaps relapsing or not achieving SVR, you won't know what really caused it....You're treatment failure or relapse will go into the databases that doctors and patients and drug companies rely on to see how this new drug(any new drug) is doing in the real world. 

In other words, by drinking you're hurting yourself and the thousands of others around the world who are either working night and day to come up with the best treatment, and the scores of patients that are weighing which drug options are best for their genotype and condition...

So please, for your sake---you are worth getting cured---and for the sake of all fellow hepC patients, please get the support you need to stop drinking....

Meg.

[DisabledHepcat]

Disabled Hep Cat - Although I don't drink and I am concerned about alcohol use and liver disease, I am deeply disturbed by this trend in insurance. It may be left over from the old interferon days when the decision made sense. This current trend is not medically-based and I think it is a way to keep cost down. Denying treatment to people who won't fight back may be a business decision. It fries me.

You are the only reply who replied to my post correctly, Your right - Interferon treatment is affected with alcohol intake since it disturbs the immune system. Harvoni attacks the virus directly and has no drug related interactions with alcohol like St Johns Wort or antacids do etc. The bottom line is if you do drink alcohol and have HCV you can destroy your liver 10 fold, however using Harvoni to rid your HCV will drastically reduce liver damage even if you drink. It's discrimination - especially since not eating right can destroy your liver also. I knew how to use whey protein isolate and other liver protecting foods and supplements throughout my years of HCV which kept me from getting Cirrhosis while doing some binge drinking which is protected by drinking coffee.  For we intelligent people the insurance laws do not apply.

[MEG]

Lucinda and DisabledHepCat,

I don't understand your position: We know that alcohol fuels hcv replication. Harvoni, indeed, does directly target the virus. Just imagine, if you will, that H is in our blood scavenging for hcv and while by drinking we are producing more and more virus for it to kill.  Imo, giving it less opportunity for it going deep into the liver or other body organs where the virus sequesters itself.

To me it sort of feels like taking chemo for the lung cancer that is most associated with cigarette smoking and continuing to smoke at the same time.

Is there data to support alcohol consumption not negatively impacting Harvoni SVRs?

 It's a risk that I am not willing to take for myself. 

Re: denying people who drink alcohol. My sense is that the insurance companies associate alcohol use with other high risk behaviors----even if it's an unfair stereotype for particular individuals, I think they want to cover all bases because it's too hard to assess and ascertain that people are living otherwise healthy life-styles---that is, if indeed alcohol does not impact H's effect and SVR---I remain concerned until I see epidemiological studies that look at this

Fwiw, My doctor's nurse practitioner who did the H teaching with me said that alcohol speeds the elimination of H through the body and instructed me not to drink. The written instructions at the top of the patient guidelines page instructed  against alcohol during treatment.

[Roger]

How did this topic come up?

Anybody with HCV who drinks is crazy - with or without Harvoni.
Period.

Jeez.... that is a no brainer.

[Mike]

Research is not conclusive regarding alcohol consumption and increased viral loads. In fact, when this topic is investigated via a meta-analysis methods, the following is noted:

"Alcohol has no effect on hepatitis C virus replication: a meta-analysis"

'Abstract

Background: Patients with chronic hepatitis C virus (HCV) infection who consume large quantities of alcohol have more severe liver disease compared with HCV patients without a history of alcohol consumption. The mechanism by which alcohol worsens HCV related liver disease is not properly understood. One possibility is that alcohol stimulates HCV replication, and the present meta-analysis was performed to examine this issue.

Methods: The effect of alcohol on viral titres was assessed in three ways: comparison of the heaviest drinkers with non-drinkers; effect of graded doses of alcohol; and effect of abstinence in the same individual.

Results: A total of 14 studies were identified. Comparison of patients with the highest alcohol use with the abstinent group showed a significant association with viral load in three studies, five studies had a positive direction, while the remaining four studies found a negative relationship. Analysis of the combined results showed no association between alcohol consumption and virus levels (p = 0.29). Assessment of graded doses of alcohol also showed no significant difference between non-drinkers and moderate drinkers (p = 0.50), between non-drinkers and heavy drinkers (p = 0.35), or between moderate drinkers and heavy drinkers (p = 0.32). Five studies examined the influence of abstinence on viral titres but none provided sufficient data for statistical analysis.

Conclusions: The present study has failed to show an association between alcohol use and HCV viral titres. These observations raise the possibility that the hepatic damage caused by alcohol and HCV may be purely additive, involving different mechanisms and pathways.' "

Best wishes, Mike

[nicole_1234]

My doctor told me they were testing me for alcohol and marijuana because of the cost of Harvoni, they do not want to take the risk to give the medicine to someone who might handle it irresponsibly. You are right that is discriminatory.

I agree that alcoholism is a disease and not someone just being "crazy" to drink, and they deserve to be treated as much as someone who's an addict with cancer deserves access to chemotherapy. My father was an alcoholic who battled it his whole life and died at 67 from cirrhosis. He also had Hep C and the who knows if he could have lived much longer, even still drinking but without the Hep C??

Although, if I were a doctor I would try to get someone in to treatment for addiction first before starting Harvoni or at least at the same time because I think it can't be helpful if you are drinking heavy amounts while trying to cure Hep C.

I choose not to drink alcohol at all or even take herbal supplements or anything that could interfere. Alcohol (and sugar, fried food) definitely taxes your immune system whether it interferes with Harvoni or not and I'm trying to give my body optimum strength to fight this.

[MEG]

Thanks for posting that, Mike.

Not sure how much this analysis helps. Going by metastudies can be a problem unless you can see the studies they looked at to ascertain  they all had uniform rigorous testing or not.

We know that hcv titers are all over the place...did these studies note trends of viral titers for each patient? For example, I've been running 500K+2million over 20 years.

Those p values are not strong. Anything above 0.05 is worrisome re: any conclusions they make.

Do you have a link to this paper? I've been doing pubmed  and google searches and have not been able to find anything.   

I am also a nurse and although I am not working I would want to know not only for myself but to prevent my giving wrong information to any other person with HCV that I may interact with outside of the online boards.

[MEG]

Nicole,

I'm so sorry you lost your dad at such a young age. My uncle died of his alcohol induced cirrhosis at age 56. He was an amazing person. I still miss him. Several in my family struggle with it and dear friends, who are wonderful people,  struggle with it every. single. day. My addictions are different. Cigarettes---chain smoker. And it took getting bed-bound sick with this virus for me to quit. I still want one every day. And do relapse from time to time.  I have absolutely no judgement of addicts of whatever substance...

Although, if I were a doctor I would try to get someone in to treatment for addiction first before starting Harvoni or at least at the same time because I think it can't be helpful if you are drinking heavy amounts while trying to cure Hep C.

I know of some doctors and medical centers that try to get people in treatment before beginning hcv therapy. I don't know how across the board it is around the country. I suppose it depends on resources available.

I feel the same as you---since diagnosis, my aim has been to remove as much burden as possible from my liver so it can 'more energy' to fight the virus. 

Not everyone manages illness in the same manner and that's ok.

[MEG]

Mike, this MD from Boston University explains the concerns about metastudies and in particular this one much better than I was able to articulate.

Comments:
This meta-analysis did not find a consistent association between alcohol use and hepatitis C virus replication. The conclusions from this study are limited due to its small sample size, differences in how studies defined heavy drinking, the cross-sectional analyses, and lack of control for the quality of the studies, duration of alcohol use, and antiviral treatment. However, while the mechanism of liver damage from co-occurring hepatitis C and heavy alcohol use remains uncertain, the recommendation for patients with hepatitis C to abstain or minimize alcohol use remains unchanged.

Kevin L. Kraemer, MD, MSc

[Mike]

Here's a summary of research conducted by the VA:

"Hepatitis C and Alcohol

Alcohol and hepatitis C are certainly the two primary causes of cirrhosis and liver transplantation in the United States and Europe.(1,2) Many patients with hepatitis C from these regions also have a history of problematic alcohol use, and thus have liver injury from both agents. An unequivocal first step in the management of patients with HCV who have an “alcohol problem” is ensuring that alcohol cessation is put in place. This section describes what has been shown about the interaction between alcohol intake and chronic hepatitis C infection.

Several factors have made this area of study difficult:

* the fact that alcohol intake varies over time in nearly everyone, and is thus very difficult to quantify

*alcohol likely affects individuals differently (for example, it seems that only 20% of heavy drinkers develop cirrhosis).(3)

These limitations should be considered in the interpretation of the studies discussed.

Alcohol and Liver Disease in Patients with HCV

Since the discovery of the hepatitis C virus in 1989,(4) heavy alcohol consumption and hepatitis C have been known to interact with each other in causing liver disease. Poynard et al (5) were among the first to demonstrate that heavy alcohol intake (50 grams/day or more in their study) contributes to fibrosis on liver biopsy in patients with HCV independent from other predictors. This intake is equivalent to 5 or more drinks per day (an average "drink"--one 12-oz beer, 5 oz of wine, or one 1.25 oz shot of hard liquor--contains approximately 10 grams of alcohol).

Numerous other studies have confirmed that heavy alcohol intake contributes to HCV-associated liver disease. Notable among them is the study by Roudot-Thoraval et al, which evaluated more than 6,600 patients. Heavy alcohol intake in this study was associated with significantly more cirrhosis than was smaller amounts of alcohol intake. Another important study was that of Ostapowicz et al,(7) in which patients with HCV who had undergone a liver biopsy had a detailed lifetime alcohol history obtained. Daily alcohol intake was not associated with fibrosis in multivariate analysis, but patients with cirrhosis had greater total lifetime alcohol consumption than did patients who did not have cirrhosis.

Limitations of studies published to date have included grouping subjects by fixed categories of alcohol intake,(5) and using case-control methodology, with cases often having cirrhosis and controls having little liver disease. Studies including light drinkers have had conflicting results. Ostapowicz et al (7) found no significant relationship between light or moderate alcohol intake and fibrosis on liver biopsy."

The research suggests that moderate to heavy alcohol consumption (2-4 drinks per day), in some infected by HCV, can accelerate liver damage. However, the research does not address occasional alcohol consumption of 1 or 2 drinks per week, and it is doubtful that this amount would cause any damage.

Best wishes, Mike

[Tiger]

Hello everybody.

Interesting topic - there are multiple threads about "Starting Harvoni" and that came is and also a related topic came up there as well.

My personal opinion - I concur withe several of you:
- no judgement of any addiction - been there, done that
- if you suffer from addiction, perhaps this treatment should be combined with some rehab or something so that you stay away from alcohol and/or other potentially interfering substances at least while your're on this treatment
- if you have Hep C you should stay away from alcohol, period
- if you're on Harvoni, it is not only irresponsible to take alcohol regardless of any studies, but it is disrespectful of all the others all over the world who have no access to this new cutting edge treatment and would give anything for it if they could, while we here are debating whether we should give up drinking for a few weeks
- I must say, if the insurance company has to make a choice between providing this treatment to somebody who is willing to stay away from alcohol and drugs in order to get it and somebody who doesn't care - I would have no problem supporting the first choice - I think it would be fair
- again, addiction is a different matter and then please see my first and second point above

Now, I have a question related to this topic, but yet very different in my opinion. This is about weed and would love to her what you all might know and/or think about it. As I said this topic came up elsewhere on this forum so please follow this link for a reference:
 http://forums.hepmag.com/index.php?topic=1806.msg14715#msg14715

Thanks and best of luck to everybody!

[MEG]

Hi Tiger, re: marijuana. I found this study which shows that it's ok. But I'd need to see more studies to confirm it.   



http://www.ncbi.nlm.nih.gov/pubmed/25157529

[Tiger]

Thanks, MEG!
That's what I thought - THC shouldn't really have anything to do with liver...
Alcohol on the other hand, has everything to do with liver...
Well, I'm taking no chances anyway - will stay totally clean till at least 12 weeks post EOT and then we'll see - by then it will be like almost 9 months without weed or tobacco, so it would make perfect sense to just keep on...
However, if it's not SVR, God forbid - then I will definitely go get a stash and will never again consider life without it...

[Tpropane]

All that I know is that on one of the 3 denial letters I received from Blue Shield before I was approved contained a sentence and I am paraphrasing here. "Blue cross will not approve and reserve the right to deny Harvoni for abusing alcohol or illegal drug use." I called my doctor and made it clear I was no longer even drinking the occasional glass of wine. My Drug of choice is wine. To be honest it was the hardest thing in the world for me to give up. But my liver went from nearly normal or NAFLD F1 at EOT on Boceprovir, riba and pegintron relapse in 2011 to bounce back in 2014 to full blown cirrhosis. I think boceprovir once failed caused the virus to come back with a bang. But I am merely speculating. My doc and I sat around and did nothing for 4 years. Waiting for a Harvoni, I guess. Yes I drank wine during that time. Not a fifth of tequila, no hard liquor at all. I'm talking a glass or 2 of wine a night. Those of you with old liver results. Throw them out the window. Only very current tests will determine your status. It was like lightening, in the blink of an eye. Unless the first biopsy and ultrasound were wrong? But the cirrhosis was confirmed by blood tests, fibroscan ultra sound and cat scan. No cancer spots but my biggest concern of course. I think I got my docs attention when I said, "Which right to die state he would move to? Washington or Oregon?" Then the results said no liver cancer. May the odds be ever in your favor.
It scared the wine right out of my glass.

[Roger]

There are so many alcoholics out there (in the world) that hide behind the 2-3 glasses of wine per night...  They 'aren't alcoholics though'... but get them to put down the glass with 'ease' for a mere 30 days.  Ha! Nearly impossible.

All of us are sooo lucky that we received Harvoni - a 2nd chance. Not one of us should even consider taking another drop or anything else for that matter.  Frankly, I had enough wine, beer & liquor for 10 people. I haven't had a drop since June 2009.  With the HCV AND the alcohol eating away at my liver, I knew I had to give up the drink, in order to stay alive long enough for Harvoni to be invented.

I remember reading a post on one of the forums that the poster 'just couldn't wait' to be able to go out and drink beer once again.  It's like playing with fire.  Alcohol is romanced all over the world.  It's cool, the nose is wonderful, etc, etc, etc.  Alcohol is actually poison.  Anyone who has been given this second chance should not take it for granted.

I'm just saying...

[Tpropane]

True dat Roger. No doubt. However I try to justify it. I needed my wine. 8 weeks sober but still a little raw. Just dealing with this crap one exhausted day at a time. Staying away from triggers of parties and food and drinking friends.
I never expected life to be easy but sometimes I can't be happy about it being so hard.

[Tiger]

Hi Tpropane - I hear you... and feel your pain! That's why may I suggest to light up some ganja?

[Tpropane]

Roger I know. It's legal here. I have a prescription. I just haven't found anything that doesn't make my brain think more! OG strain is what was recommended. It all just gives me the munchies! I wish I liked pot, but I'll keep trying!

[Roger]

I don't want to sound corny, but frankly - who needs to get high?  I mean really - who? Why?  I entertained a lot, which was a great excuse to abuse alcohol.  I had a lot of parties, all of which were excuses for people to get hammered.  After I gave up the drink in 2009, I still had parties, only I became the enabler... I can keep a persons glass full without taking a sip.  (Wasn't always like that though)  I love parties, and having people over.  Everyone who comes over knows that I always have great hard liquors on hand, as well as beer & wine.  I'll still pour it for you... I'll even take a smell from your glass - but that's it.  The stuff is just too dangerous.

To 'think' that one 'should' or 'must' stop drinking because this or that, typically doesn't work too well. At least it didn't for me.  AA is full of people with stories like that... but for us - people with hinkey livers, we have a great reason to stop drinking... It's called life!

That's a pretty good reason to not drink!

[Tiger]

> who needs to get high?  I mean really - who? Why?

Well, like, a lot of people... for a variety of reasons, but mostly stress...

Sounds like you're a great host and your parties is the place to be - I always had utmost respect for enablers - host entertainers whose biggest fun is making sure that guests are having fun.

I know a lot of people just can't do a glass or two and it's all or nothing for them - in that case, sure nothing is the way to go, but for those who can enjoy just a drink or two occasionally, I think there's nothing wrong with that.

We on the other hand - the Hep C community, are a different matter - no booze for us, period... Well, maybe in a few months if all goes well I'll be able to have a glass of wine without feeling guilty and then without my liver telling me that was not a good idea...

[moma]

Come on, it doesn't matter what anyone says, Hep c and alcohol do not mix. There is no question about it. This was not easy to accept. I come from a long line of  Guinness drinking, Bailey's sipping, Bushmill pounding, Irishmen. Yes it is a struggle, but if I can stop drinking anyone can.
MoMa

[MrMcSwifty]

Hello everyone.  First time poster.  Sorry for a long one, and I hope it doesn't rub anyone the wrong way, but I felt compelled to chime in on this topic.

First, a little backstory: I'm a 33 year old male, diagnosed with HCV last February, although I must have had it for at least the last 12 years or so, since I was an intravenous drug user during my teens (early 2000's).  My ALTs at the time of diagnosis were in the 100's, viral load about 1.1 million, GT3a.  Also been a heavy drinker during pretty much this entire time; a daily beer drinker for the last 5 or 6 years.  Luckily, in spite of that, I do not have any liver damage.

One thing I learned since then, when lurking around the various HCV support forums, is alcohol is a taboo subject.  Any discussion about it often gets shut down immediately.  (As Roger put it, why even have it?  You're crazy to drink alcohol with HCV.)  And that's a shame, because I think it's absolutely a conversation worth having, and at this point I think the idea that alcohol, no matter the amount, will rapidly accelerate the rate of liver damage for anyone with HCV infection is a bit archaic, and frankly, extreme. 

Maybe that makes me crazy, but I would prefer to call myself pragmatic. 

Because we see most of these studies done on the effects of alcohol with HCV infection are typically done on moderate to heavy drinkers.  As in, at least two or more drinks PER DAY.  If you're really drinking that amount, than you're almost certainly doing damage to your liver as it is, regardless of HCV infection.  And even then, depending on the survey, the impact is often found to be negligible or inconclusive.  Yet for some reason we take the negative results and act as if they apply to folks who might drink that amount in a week, or a month.  Worse yet, we see people getting denied treatment by their insurance companies because they have an occasional drink, or because they have a refused to submit to a substance abuse treatment program.  What a joke!

Speaking for myself, I was fortunate that none of this was the case for me.  Since my own diagnosis, I have greatly reduced my alcohol consumption.  I would consider myself sober, but that doesn't mean I abstain completely.  I drink in moderation, down from a daily 6-12 beers, to maybe 4-6 a month, if that.  When I met with my GE for the first time in Sept, I was honest about this.  When discussing my past alcohol abuse, he of course asked me the amount I currently drink, and when I told him he basically chuckled and said, "Oh.  I'm not worried about that." 

Insurance company didn't seem to care, either.

Also, as for what MEG says about alcohol fueling viral replication, I have seen this mentioned before but I have never found anything to support it.  Any studies I've come across seems to indicate that there is either no correlation between alcohol intake and viral load whatsoever, or at best the results are inconclusive. 

Speaking again from my own personal experiences, my VL has been consistently between 1.1 and 1.8m during the (appox 9 months) between diagnosis and the start of treatment, despite my significant reduction in alcohol intake.  (In fact, it was highest at the start of treatment in spite of having not had a drink weeks!)  So this certainly contradicts the theory that drinking increases VL.

What we do know, of course, is that alcohol does damage the liver, and that damage can increase tenfold when it's already under attack from an HCV infection.  This should be pretty obvious really, and I don't think anyone, alcholohic or otherwise, would try to deny it. I just don't think that alcohol interacts with the virus directly. (although I'm willing to admit I could be wrong about that)

So I guess my point is that there's a bit more grey area than many doctors, insurance providers, and even HCV sufferers themselves are willing to consider.  Not everyone with HCV has liver damage, or cirrhosis, and not everyone who drinks has a daily habit.  Obviously, the ideal amount of alcohol we drink should be zero, but as my own GE put it, "you could inflict more stress on your liver by eating a fatty meal than by having a couple of glasses of wine over the course of a month."

And my test results do reflect this.  I'm now 10.5 weeks into my Solvaldi/Riba treatment (I know it's not Harvoni, but really it's the same stuff).  Been undetectable since week 4.  Liver levels have been in the 20's since week 2 (latest test, on Feb 11, I was 22ALT/18AST).  I have suffered no ill side effects from treatment, other than a drop in red blood cells in the first two weeks, which quickly jumped back to normal range on the next test.  By all accounts, things are going swimmingly. 

Obviously, we will have to wait and see how it turns out in the long term, but I'm feeling good about it, and don't feel I have any reason to worry.  In the meantime, if I feel like having a drink, I'll have a drink, and I'm not going to feel bad about that.  I don't think there's any reason to deny ourselves the things we enjoy (within reason) just because there's a slight chance there might be a some negative impact.  Certainly, I'm not encouraging a cirrhotic with HCV to go out and get plastered, but I do think we can apply some common sense when considering just how much damage small amounts of alcohol will really have on an individual basis.

To anyone made it all the way through that wall of text: thanks for letting me rant.  You guys are great.   

[Tiger]

MrMcSwifty, I did make it through your post...
Firstly, lucky you to be 33 - that's probably the primary reason why you don't have liver damage - your body is young and strong and it is really great that you're going through the treatment and it goes swimmingly - it should all be good.

I do understand your argument about moderation and small amounts being not too bad - I myself did that for a few years and it seemed to not have any effect in the beginning, but then my liver started giving me signs that it was not appreciating me pushing the envelope - again it must have to do with age: the older I got the more I could feel that even one drink was not doing my liver any favors.

So two things:
1. No question that alcohol puts strain on the liver because it has to be processed there and when the liver is already under attack, putting extra workload on it is not a good idea at all - therefore, it is common sense that if you have HCV you should avoid alcohol as much as possible, and of course the more damage there is to the liver the more so...
2. What worries me much more, though is you saying: "if I feel like having a drink, I'll have a drink" - hope you don't mean now while you're undergoing treatment! because if you do, that would be the most irresponsible and dummest thing to do, not because of what alcohol would do to your liver, but because nobody knows what the interaction of that $100K medication and alcohol may be - it is possible that by having that drink you are canceling out your entire treatment. So please stay away while you're taking those miracle pills and once you're off them and cured (keeping fingers crossed) you can do whatever you want. You have to remember that there are thousands of people out there who are not lucky enough to be able to get this treatment and drinking while on it would be an insult to all of them.

Good luck!

[Mike]

First, it is not correct to say an occasional alcoholic beverage puts a strain on the liver. Rather, alcohol abuse puts a strain on the liver.

An occasional drink here or there does not strain the liver and can be metabolized very efficiently in the same manner as a diet coke, 7-up or any other sugary drink, medication (Tylenol, Lipitor et. al.) and so on.

However, binge or heavy drinking can strain the liver as the body (including liver) cannot metabolize it fast enough, which is why it causes intoxication. It is the delayed metabolism that causes damage (i.e., drinking more alcohol than the body can efficiently metabolize at one time).

Should a person infected with HCV avoid alcohol, probably (and most definitely if there is a hx of abuse).

But the suggestion that an occasional drink (1 beverage here and there) is equivalent to "throwing gasoline on a fire" is fallacious.

Lastly, I'm not encouraging people to drink or suggesting that anyone start drinking. I am, however, suggesting that taking wine during communion or a beer or two on a hot summer weekend is no more dangerous than eating the occasional pork rib, or a big, fat-infused ribeye steak or an occasional glass of butter milk.

Best wishes, Mike

[Tiger]

Mike, what you're saying is very reasonable, however, the best thing is to listen to your body. For years I did exactly what you're saying - I wouldn't really restrict myself and would have a drink or two here and there. But then I started feeling that those one or two drinks were not really doing any favors - I would get that strange unpleasant feeling in the liver area in about 10-15 min after that one drink and then I would get hangover-like symptoms the next day after half a bottle of wine, which is basically two glasses - that never happened before even after 2-3 times that much... So, would a drink or two ruin you liver - no, especially when you're 33, however will it put extra strain on it - sure, and the older you are the more so. Well, I'm 53 - will I have a drink again, sure, but not before EOT and probably not before 12 weeks after that, and then we'll see how it goes.

[Mike]

Hi Tiger,

I totally agree. We need to listen to our bodies and avoid things that do harm.

Avoiding alcohol while dealing with an HCV infection is a good policy and practice.

An occasional drink (1 here and there) is a controversial - with a couple of schools of thought.

It's a good topic to explore in this forum, as there are a lot of mixed feelings about this.

However, there should be no confusion regarding moderate and/or heavy alcohol consumption: It does accelerate liver damage and it appears to have a synergistic effect when combined with a HCV infection.

Best wishes, Mike

[Tiger]

Just found this:
http://forums.hepmag.com/index.php?topic=2016.0
Very noteworthy!

[MEG]

Thanks so muchTiger---how fascinating what just one month of abstinence can do. Incredible, really.

To all, I truly have appreciated this dialogue. I'm learning much and my mind/opinion is reevaluating what I've felt to be absolutely true about drinking and hcv replication, for example.  The truth is that some studies show that alcohol increases its replication and others don't----I think that an inherent problem with these kinds of studies, unless they follow individuals over the course of a medium/long term time frame, is that because our viral loads tend to go all over the place, it's basically a roll of the dice re: what a trial participant's viral load will be, whether he/she drinks.

Ho, W. et al. Alcohol increases hepatitis C virus in human cells, Hepatology,   

http://consumer.healthday.com/encyclopedia/hepatitis-c-23/hepatitis-news-373/alcohol-and-hepatitis-c-645166.html

I completely agree that it's an important discussion to have---for people to feel safe to discuss their drinking without judgement. I disagree with people who drink, especially on treatment, but I have no data to prove that I am correct.

As I said in another post--not sure if in this thread or another one---my goal since diagnosis has been to reduce the toxic load of my liver as much as I can.

Because I was approved for only 8 weeks and I have the tougher to cure 1a genotype, I feel that it's even more important for me to do what I can to maximize Harvoni's utility for these precious weeks. 

For those who are drinking and haven't told your doctors I encourage you to think about telling them. This is very important for the long-term studies of what works and what doesn't work to achieve SVR. For them to tease out and make more conclusive judgements re: alcohol's influence during DAA treatment.

Let's keep the conversation going.....wishing you all a peaceful evening and undetectable levels, asap.

For those truly having difficulty stopping drinking even though you know you should, hcv notwithstanding, along with other programs in your home area, we here are available to support you---without judgement. We all have vulnerabilities and struggles that we often endure within the loneliness of our own hearts...and  sharing them with others who care can mean the difference between life and death. I know this to be true in my own life...

[nicole_1234]

My doctors tested me for alcohol and marijuana before I began treatment and at 8 and 12 weeks (i peaked at my nurses paperwork, they wouldn't have told me they were doing that)

I used to have a harder time not to drink socially. It made me feel left out. But now I don't care, I don't want to feel bad. I spent many years running half steam. And especially on treatment, I can't imagine.

I also think if it doesn't work, I don't want to be mad at myself thinking there was something I could have done better.

[donk]

As far as myself, 1 beer leads to 2, 2 to 4, 4 to 8, you get the picture. I've been at 0 since 2003 when I first did treatment and plan to stay there to the end. Not a big deal but social situations with people drinking is difficult. I just limit my exposure to drinking situations. My health is more important than drinking. Alcohol was my first drug of choice which lead to others ultimately leading me to HCV.

[dragonslayer]

I gave up drinking a few years back, and Ive got to admit, its put a big crimp in my social life.  Its just hard for me to be around drinking people and the liquor fueled dialogue and behavior which results..   I miss the fun and comraderie that drinking elicits.  But I sure dont miss the hangovers, drunken arguments, and lack of clear thought and judgement which more often than not develops.   Still, when we're out to dinner and having pizza, for instance, nothing looks better to me than  a nice, tall cold one.. Still, I abstain.. Grit my teeth and bare it.. Is this what they call white-knuckling it?  I think so. 

But, given my recent EOT result of Not UND, if I had been drinking during treatment, I can tell you the amount of consternation I would have had to endure would have been intolerable.   Until I clear this thing,  its no drinking for me.  But I cant say Im thrilled about it!

[Roger]

I gave up drinking a few years back, and I've got to admit, its put a big crimp in my social life.  Its just hard for me to be around drinking people and the liquor fueled dialogue and behavior which results..   I miss the fun and camaraderie that drinking elicits.  But I sure don't miss the hangovers, drunken arguments, and lack of clear thought and judgement which more often than not develops.   

Before being told I had HCV, I tried to stop drinking several times, over the years.  I didn't want to stop, I just 'thought' I should, etc.  That method never worked very well.  I had excuses about the 'social' aspects, feeling like odd man out, and so on...  Frankly, all that was in "my" head.  In reality - nobody cared (except me).

Once I learned about the damage HCV was doing to my liver, and admitted how much damage alcohol must have been doing to my liver over the years - it was a no brainer.  I couldn't quit one of them, but I could certainly quit the other (alcohol).  "Knowing" that I was going to die a horrid death if I continued mixing these two things also made it easy for me.  I had seen a friend die from cirrhosis (after I quit alcohol), and it was so ugly that that alone would have 'almost' been enough to make anyone stop drinking.  I am talking scary ugly.

Early on, when people were getting use to me drinking only soda water from a wine glass, or tea from a beer mug, I would tell them that I am stopping - that I've had enough alcohol for 10 people.  That always sufficed. No preaching. No AA.  They could laugh and relate at the same time.  Frankly, it probably sent them into their own soul searching.  How much alcohol has the "2 glasses" person actually consumed? How many "2 glasses only" people drink far more "occasionally"? (define occasionally) Most people (I know) lie about the amount of alcohol they consume. So many of these "2 glass" conversations came up over the 3rd or 4th glass.  If there was a 'conversation' about how much one 'drinks', there was probably a lot of lying going on!

So I don't let my abstinence spoil the party or put a crimp in my social life.  It's really no big deal to others if I drink or not, especially those who understand "why" I have stopped drinking.  Those are real friends, who understand that my liver can (could) only take 'so much', and they understand how damaging alcohol really is - on it's own (without HCV).  Yes, 'they' elect to drink and potentially damage their brains & body, but being my friends, they understand that I don't.  Frankly, I think, that they think, they would be lesser a friend if they scorned, laughed or pressured me into taking another drink.  That's friendship. It's hard to find.  Drinking buddies are a dime a dozen...



 

[MEG]

I was in my early 30s when diagnosed and led a very active professional life(ICU nurse---and we're known for partying!) and personal life which included friends who loved drinking, smoking cigarettes. Some ventured into the other agents du jour but I was terrified of them for some reason.

Because as a young teen I'd seen my dear uncle slowly die of cirrhosis while in his late 50s, I always had this fear/guilt in the back of my mind for drinking. Although I generally ignored it.

By the time I got diagnosed with the HCV, there were 3 things that made it easy to stop: 1) the only other person I knew that had it was a respiratory therapist colleague who received while priming blood tubing and he became cirrhotic in a matter of months. He was beloved by the entire staff and it devastated us to see him go down so fast. 2) My uncle's death came to the fore and 3) I was so sick that I'd already drastically curtailed while trying to figure out what was going on.

For some reason, decaf coffee or soda water with lime became my go-to's. Like you Roger, my friends completely understood. And the truth is that I was relieved to have a real excuse to stop. The fear of dying like my uncle and the extreme pain it cause our family to lose him had lurked much greater in my mind than I'd allowed myself to realize...

I continued to go to gatherings where alcohol was consumed but my now late-husband came into my life. He did not like to drink. Even though his parents were consummate wine drinkers. And it worked out well.  It wasn't a part of our personal life style but we were fine with friends who did. 

Now, 30 years later, I do have friends who are struggling. 2 of them are "functioning alcoholics." And they know it and they can't seem to come to a place of either, 1) yes, I drink more than I should but i"m healthy and I'm going to keep drinking. 2)I'm quitting because this is too much. Therefore, I get many phone calls from them describing their regrets after a bad nite. The self-loathing is awful. Yet, they can't come to peace in either direction. I feel terribly for them. That has to be so hard====going back and forth. One friend confides that each day when she wakes up her mind starts battling re: whether and how much to drink at dinner that nite...Ouch.  She's a tremendous person. I constantly pray for her healing...

[MrMcSwifty]

Tiger, you're right, my relative young age is definitely something I have going for me.  All things considered, I'm extremely fortunate to have caught this when I did, before suffering any major damage to my health in spite of years of substance abuse, and obviously that I'm responding as well as I am to treatment. 

I also think my age probably plays a lot into why I have such a different perspective on this topic.  I understand that most of you are much older, and have been dealing with this for much longer than I have.  Many of you have failed treatment, even multiple times.  Considering that, I completely understand why it might seem... insulting... to see someone like me, granted the gift of these new miracle drugs, and then act like I'm not taking it seriously.  Believe me, I get that.

The thing is, these new drugs are a very different animal, and I don't think a lot of the old rules apply the same way they did with the interferon based treatments.  Just a few years ago the cure rates were already much lower to begin with, and this was only exacerbated by continued substance abuse.  With the newer options however, it seems there is very little evidence to suggest that light drinking negates their effects or treatment outcomes, and at least some evidence to suggest that it doesn't.

So I don't really feel like my situation should be insulting to anyone. I have two doctors that I trust implicitly (my primary, and my GE), and I have been very open with both of them about my past and current alcohol use.  Neither are "enablers," or have ever downplayed my drinking habits; in fact, my PCP in particular has been very vocal about it, and that's also part of the reason I trust her so much.  In both cases, however, they don't feel that my current level of drinking is any cause for concern, that it was worth it to go forward with my HCV treatment, and my insurance company apparently agreed.

For the record, I was sober for weeks at a time throughout last year, and my ALTs fluctuated from the low 30s to high 50s, down from triple digits at diagnosis, right up until I started treatment on Dec 10th, where they dropped to 27 by the second week.  I abstained completely for about 4 weeks prior to my start date, and through the first five weeks after.  The weekend after I got my 4 week results back (undetected), I did celebrate with a beer.  I also had about 4 drinks in January, and two more while out to dinner just this past Valentines Day.  All told, I don't think 7 drinks since being undetectable is all that bad, and my ALTs have remained in the 20s since then, as well.

That's just my situation - and while my heart aches for those who aren't able to get on the new drugs for whatever reason - that's entirely on their doctors/insurance provider, not on me.  The real problem lies with these doctors and insurance providers that refuse to treat people who don't abstain completely, despite the evidence that this may be unnecessary.  Or, in some cases, with the patients themselves, who do have a problem but who simply refuse change their behavior even at the behest of their doctors and insurers.  Whether I abstain or not isn't going to alter my outcome, or theirs.  Everyone's situation is different, this is what everyone involved with mine has agreed is right for me, and the proof is that it's working!

Ultimately, we probably aren't going to agree on this issue, and I hope no one here thinks I'm dismissing their opinions or trying to preach.  I know this is only my second post but I've lurked here for a long time and I'm familiar with many of you guys and what you've been through.  I've spent a lot of time here reading about other people's experiences and appreciate those who are willing to share them; I'm just doing the same and this is mine.  Hopefully that's not upsetting to anyone.

[Mike]

One thing that should be clear is that insurers do not deny treatment for occasional alcohol use; rather treatment denials are rendered due to alcohol "abuse" and or dependency - both of which have a specific clinical definition.

Best wishes, Mike

[Tiger]

Hei, MrMcSwifty,

You're right, you're extremely lucky to be 33 and to have caught it relatively early and also after all these new things have just been invented.

You're also right that your age does determine your perspective - honestly, I wish I was your age and able to look at things as lightly as you do - I certainly miss that very much and regret that I can no longer afford that! Believe me I do no know how great that feels! that's probably why I part of this forum in the first place...

You're certainly entitled to your opinion and it's your choice what you want to do and it's not my intention to judge that at all - I sincerely hope you're right and my fear and concern is outdated and does not apply to this new reality with these new treatments and that it was only valid for older interferon treatment for HCV and also various antibiotics treatments for a variety of other ailment, maybe even no longer for them either...

Still, couple of points, though:
Firstly, I want to refer you to @dragonslayer's post above: http://forums.hepmag.com/index.php?topic=2214.msg14957#msg14957
I hope and pray nobody finds him/herself in the situation described in the last paragraph of that post. Honestly, if nothing else I would have stayed away from drinking for that reason alone...

Secondly, I encourage you to look at things from a much wider - global perspective: it's not about just people in this great country and their doctors/insurance providers. There are millions of people out there that can't even see a doctor... What I'm saying is that we have no idea how lucky we are and how little we appreciate what we have and have access to.

Wishing you all all the very best and to get rid of this damn thing.

[MEG]

Dragonslayer...have you seen this new thread re: how they report viral loads? Worth checking into?

http://forums.hepmag.com/index.php?topic=2236.new#new

[Mike]

Please note that the topic of this thread is on Harvoni and Alcohol and posts should relate to this subject.

Best wishes, Mike

[MrMcSwifty]

Mike,

That's true.  I do have a history of alcohol abuse in my medical records, which my GE actually told me would probably be a hindrance to my getting approved.  That luckily turned out not to be the case.  There were never any follow queries or blood tests, nor did I have to submit any proof of abstinence.  I was approved within a couple weeks.  For that I was both surprised and grateful.

It probably helped immensely that my blood tests showed significant improvement in liver functions since diagnosis, which would suggest in itself a decrease in alcohol consumption.  Also, that I've never been diagnosed with true alcoholism/dependency (and did not experience any withdrawal symptoms when I "quit," either).

As I've said, no one involved with my case seems to think that the occasional drink is any issue, and I have no reason not to trust that.  Only time will tell, I suppose.

Tiger,

Yeah, I'm familiar with dragonslayer's unfortunate situation, and it's definitely something to consider. 

[MEG]

Mike, if you're referring to my post to Dragonslayer, I apologize...I didn't know how else to best point him to that board.

Thanks and I'll remember this.

[dragonslayer]

One thing that should be clear is that insurers do not deny treatment for occasional alcohol use; rather treatment denials are rendered due to alcohol "abuse" and or dependency - both of which have a specific clinical definition.

Best wishes, Mike

Mike, I have read on these pages of individuals getting tested at the behest of their insurance companies for alcohol and illegal drugs, and regardless of the extent of their usage, if the results come back positive, its an automatic decline on the coverage.    Are you saying this is not how it works, and that a positive test result is not an automatic disqualifier for those who are required to tested?

[Mike]

Yes. A person who has a 1 or 2 drinks per month, would not test positive for alcohol use unless the test was rendered immediately after the consumption. This is because  alcohol has very quick half life and the metabolites are expelled from the body within 8-80 hours (depending on the amount consumed).

However, moderate and/or heavy consumption (both defined as drinking more days then not) would probably trigger a positive result.

Best wishes, Mike

[willie g]

Native Americans call it the "MindChanger"Poison in poison out" But hey it is The all Purpose Remover" it removes furniture, kids, marriages , jobs,houses etc."  Yes it is the best Purpose remover". I wouldn't know, I have only been married 3 times( I don't go out with women I marry them and once I  go in the fridge and get my bottle of All Purpose Remover my problems are GONE, I set em up get them houses and then go down the road never looking back and the only  thing I do want is my Guitar, my scooter and. Of course my bottle of All purpose remover.  " just willie g"

[tinybim669]

Here is an article that explains sovaldi (pretty much the same) svr rates didn't change for those who drank but didn't abuse alcohol.
http://www.hepmag.com/articles/2512_20526.shtml

[MrMcSwifty]

Here is an article that explains sovaldi (pretty much the same) svr rates didn't change for those who drank but didn't abuse alcohol.
http://www.hepmag.com/articles/2512_20526.shtml

Hosted right here on this site. 

Here's a quote from another, dated Sept 2013, which if I'm not mistaken predates mainstream use of Sovaldi/Horvani, which even then suggests that limited alcohol intake should not significantly impact treatment outcomes:

Management Strategies: Discussing alcohol use results in reduced use for patients diagnosed with HCV. Moderate alcohol consumption does not appear to significantly influence treatment outcome, yet is discouraged due to the hepatotoxic effects of alcohol. Most experts do not recommend initiating HCV therapy in patients with ongoing heavy alcohol use.  Multiple pharmacologic agents are available for alcohol dependence, the most promising of which is a monthly injection of naltrexone. A multidisciplinary approach, involving personalized addiction care and case management, may be beneficial. The AASLD recommends preferably suspending all alcohol intake while on therapy for hepatitis C or limiting the alcohol intake to an occasional drink.

Link to the full article for anyone interested: http://www.hepatitisc.uw.edu/go/evaluation-treatment/treatment-addressing-substance-alcohol/core-concept/all

[Tpropane]

Mr Mc Swifty. I know for a fact. That alcohol abuse can go from 0-60 in a freaking heartbeat. Lost my hair, had sores in mouth, was so anemic I couldn't get out of bed. ALL FOR NAUGHT.  Boceprovir,interferon & ribaviron for 6 bloody months did not work. I was NAFLD not even F-1. And Zoomed from that to full blown cirrhosis in the 3 years that followed. We sat complacently waiting for the new drug that might cure me and I sat drinking wine every night trying to forget that I had HCV.
Boom! Booyah! It was a freaking shock! I didn't change or do anything differently. I drank 2 maybe 3 glasses of wine a night. Hey! Don't the French?
But my brother died in October of HCV related liver failure. I spent nearly a month in 2009 at the Mayo clinic trying to get him on the transplant list. #1 He didn't actually care if he lived or died. #2 He was a horrible patient. He hated being scoped (though he nearly died once from vomiting buckets of blood from burst varices) He had them banded a few times. He also had gallons of ascites removed from his abdomen. Several times. He had HCV 1A and never treated. He also drank like a fish most of his life. At the end however he was a disabled vet with much arthritis and bone pain and refused to give up OXY. He was in home hospice care for EIGHT YEARS!  He no longer drank but they had him PALLIATIVE on morphine and other stuff. This is not a death that anyone would want. His encephalitis made him like he had violent alzheimers. I'm sorry if I'm painting a horrifying picture. But slow death by liver disease sucks. I watched it and for my non drinking bro it took 8 years of slowly dying.
They don't give liver transplants to people who aren't 100% committed to recovery.

[Roger]

Tpropane,
How you describe your brother's demise from HCV is exactly what I experienced watching a neighbor die from it... a perfect description.  Alcohol is poison to the healthiest body, let alone a body that is riddled with HCV.  People get high from drinking gasoline, another liquid poison, although far fewer, as gasoline tastes nasty!

[Tiger]

Mr McSwifty, it sure is up to you whether you want to fully trust those "suggestions" @ 95% confidence level that "alcohol intake should not significantly impact treatment outcomes". But because I am familiar with those confidence levels I also know that there's such thing as "individual differences" which may turn anybody into an outlier placing them into that 5% that is beyond that confidence level, God forbid! I know I don't want to take any chances and wouldn't recommend that gamble to anybody else...

[Rexray]

...well this is interesting, subscribed!

[kate0b1]

@mike, im not giving up my milk lol. @Meg, i also worked in ICU for many years (adults), watching someone die from cirrhosis from any reason is horrible, it's totally on my my list of ways not to go.

kate

[Islandgirl]

Tpropane,
First, I want to say I'm so sorry about your brother and how he lived in agony and the long road to his death.  My heart hurts to think of it and I know everything you said in that post came from a caring, heartfelt concern for what he and your family went through - and not wanting anyone else to experience it.  God bless you.

My son died several years ago from liver cancer, and yes, he also had Hep C.  The VA did what they could but he'd waited too long to get help, or to stop drinking.  Your brother's story was his story too.  He died on my birthday and I still choose to consider that a gift - an end to the suffering that medical assistance couldn't fix.  They are finally free.  In another post you said that you didn't mean to come across as though you were preaching, other than to yourself.  If anyone thought you were preaching, maybe the message hit home. 

And, a joyful, happy congratulations on your 4 wk lab UNDETECTED!  hugs, ...Islandgirl

[MrMcSwifty]

Tpropane, I'm really sorry to hear about your brother.  And I do know what you mean by how quickly these things can happen.  It is a scary thought, and it's not something I haven't considered.

Just to be clear though, since this may have been lost in my previous walls o'text:  I'm not currently abusing alcohol.  I've been down to maybe a few drinks every month or so, sometimes longer in between, for over a year now.  That's down from being a daily drinker for the better part of a decade, with no ill effects in that time apart from the elevated liver enzymes, which as I noted earlier have dropped dramatically since then.  That's why I have a hard time believing that having a few drinks here and there are going to send me careening down the path to liver disease and cirrhosis now, when all tests are showing my liver is stronger and healthier than it's ever been!

Could it still happen?  I suppose so.  There's obviously some inherent risk involved, but I think the odds are in my favor so it's a gamble I'm willing to take.  I knew there would be some necessary lifestyle changes when I was diagnosed, but that doesn't mean I can't still do the things I enjoy, particularly if it's likely to have a very negligible impact on my condition.  Having the occasional beer is one of those things, and as long as I can keep up my current rate of moderation, then I don't feel that to be any more detrimental to my health than taking a Tylenol or having a sugary snack.

[MEG]

Islandgirl, I'm so sorry to read that you lost your son. What a hardship---yet here you are, choosing life, choosing good health, with a future brighter than ever as you clear this virus.
Huge hug,

[Islandgirl]

Thanks, Meg - especially for the hug  

Tpropane's post really hit home and it took me a while to be able to write to tell her how sorry I am about her brother - but it bothered me every day I didn't write.

My son chose his life path that brought his end result - I had a blood transfusion that could have brought me to the same result; fortunately I never developed cirrhosis before finding treatment .  It really doesn't matter how one gets it, it's an awful disease and I'm so thankful to now be UND after tx with Harvoni.  Today is my last pill on 12 wks of treatment and I feel truly blessed.  Looking forward to all of us facing the future and being undetected/cured for life!  Hugs to all, ...Islandgirl

PS, I never told my family about my Hep C until I was on Harvoni and reached undetected.  We all hurt so badly over my eldest son that I couldn't tell his brothers until then, they just couldn't have handled it; likewise with my mom - she now lives with me and I've been her caregiver for over 6 years, and I only told her when I started Harvoni since she knew I was being treated for something - she would have been worried every day.  Thank God for our Forum Family! 

[Lynn K]

MrMcSwifty

When I was diagnosed with hep c in 1990 and had my first biopsy indicating F0 my doctor said about drinking no more than 1 drink a month.

I have always had only slightly elevated liver enzymes no more than 5 or so points above normal and always felt fine and yet here I am with cirrhosis for the last 7 years.

I still did have a couple of beers here and there like you over the years more than the 1 beer a month suggested. I made my choices as have you about alcohol but from this side of cirrhosis looking back at you I just want to add a few thoughts.

I just hope you are considering all the potential consequences and if that beer is really worth it. Not being there for your family and death from liver disease do you really need that beer that badly why is having it so important to risk your life and health?

[Tiger]

MrMcSwifty,
You're a young man and of course you'll have a drink here and there and that will be OK once your C is gone, but, please, do yourself and your loved ones a favor and do not do that until it is gone - ideally at least till SVR12, or at the very, very least until EOT - it's also about Carma, if nothing else...

[donk]

I believe he said he is a documented alcohol abuser. Sometimes an abuser needs to go cold turkey, HCV or not.

[Karen1124]

Hep cat and McSwifty,
My feeling on this is that your best odds are not to drink during treatment. If you don't have any liver damage you should live life to fullest. I wouldn't party everyday like a big Dog, but I would not stay on the porch either! I have Stage 3 so I won't be
running with the big dogs any more. Would of retired sooner if I would of known about Hep C. So You are lucky to of found out before any damage was done. Insurance Company should not be making decisions who gets it who does not!! I believe it should be up to you and your doctor!!.......Karen Life is GOOD!!!

[Maddawg46]

How about the virus on your liver!  You should not drink a drop of alcohol.  It's like gassolene on a fire.  If I was a drinker at all, my doctor would not even consider wasting Harvoni on me.
Kaiser has to approve you by a Board.  If you drink....bottom of the list you go.  Shows your not serious. Cwhy waste money on a death wish patient.  Next.

[Karen1124]

Hi Maddawg46,
My doctor said that sugar is metabolized exactly like alcohol and told me I could only have 20 grams of sugar per day! So that is why the decision should be the doctor's decision and the patientand I really just don't have any faith in these boards that are making decisions instead of doctors I really just don't have any faith in these boards that are making decisions and over ruling a doctors decision....... Karen  Life is Good!!

[MrMcSwifty]

I'm sorry, and I don't mean any disrespect, but this idea that a single drop of alcohol is like "throwing fuel on the fire" is a complete fallacy and I wish it would just go away already.  We've been over this a few times already in this very thread, but to say it again, there is a huge difference between the occasional drink and straight-up alcohol abuse, the former which is not nearly as damaging as folks like to make it out to be.

We often talk about all the various things we put in our bodies - many of us take any number of various medications, painkillers, smoke weed, or even just enjoy sugary snacks, etc - all of which are, in the simplest terms, toxic substances that need to be filtered out by the liver.  Many of them are just as, if not more taxing on the liver as small amounts of alcohol, yet they still get the nod. "As long as you don't overdo it, it's fine." 

But mention having an occasional beer or a glass of wine and suddenly you're a "crazy person" who is "throwing gasoline on the fire" and spitting in the face of anyone who can't get treatment.  It's such a bizarre double standard. 

To be fair, I can understand the stigma when it comes from fellow HCV sufferers, many of whom have had this mantra railed in their heads from doctors and insurers for decades while waiting for the next treatment options.  It's a damn shame, however, when it's adopted by the insurance companies themselves who are now making potentially life-saving decisions based on this overblown and out-dated information.

Now, if an insurance company wants to deny someone with full-blown alcoholism, then perhaps that has some merit, simply because why should they waste such a costly treatment on someone who's just going to trash their livers and wind up needing a transplant (or dying) down the road anyways?  I still disagree with that (and it's not just me; plenty of medical professionals feel the same), but I can sort of understand why they would make that decision, from a financial standpoint.

However, it is utterly absurd for them to deny someone because they are light or even moderate drinkers, because as mentioned in the OP, these new drugs are not impacted by alcohol in any way, and there is plenty of evidence to suggest it's worthwhile to treat these patients.  The old mantra of "even small amounts of alcohol will drastically affect treatment outcomes" is no longer applicable, and it needs to change. 

Moreover, I am more concerned with seeing this disease eradicated as a whole than I am with "punishing" someone because they are not taking their treatment as seriously as some think they should.  I'm not big on karma (sorry Tiger); I'm a numbers guy, and the numbers say treatment works, even for alcohol users and abusers.

My hope is that things will change, as more options become available and the prices eventually come down to more reasonable levels, which will perhaps make the insurers far less leery about treating those whom they've deemed to be "elevated risk" patients.  Though we will just have to wait and see.

[Maddawg46]

Hi Maddawg46,
My doctor said that sugar is metabolized exactly like alcohol and told me I could only have 20 grams of sugar per day! So that is why the decision should be the doctor's decision and the patientand I really just don't have any faith in these boards that are making decisions instead of doctors I really just don't have any faith in these boards that are making decisions and over ruling a doctors decision....... Karen  Life is Good!!

When trying to qualify for Harvoni through Kaiser, they asked if I drank alcohol.  When I said no, she informed me that if I had said yes, then I would not have been considered.  That's what they told me.  It seems to be common knowledge that alcohol with hep C  is like throwing gas on a fire.  If that's changed it's news to me.  So drink up and keep thinking its like eating sugar.  See you on the other side.
P. S.  I'm an alcoholic, but I quit drinking in 1984.....so I do know a little on te subject.  I AM NOT A DOCTOR.

[Roger]

Typically, I find that most people who think about alcohol, or "only have 2 glasses a day" have a problem.  That problem is what insurance companies are looking for. Why spend $90K++ on someone who isn't serious about healing.

Alcohol causes inflammation as does HCV.  This is really a no brainer. Enjoy the fact that you have spent a lifetime of 'alcohol induced altered state'... and now you don't.  You might want to think of it as having more fun than 10 people combined, or whatever works for you, but the bottom line is - if you're trying to talk yourself into "it's ok"... you might have a drinking problem.

I know so many professional people who are hooked on booze, and in denial... but just take their "2 glasses a day" away from them for a month!  Ha!  Forget the booze and drugs. You (we) are luck just to be alive.  Life is easy without pouring poison into your body. It really is. It's all a mind set.

[donk]

McSwifty  is trying to find enablers to validate his unwise decision about drinking while on tx and beyond. People have opened up and posted the terrible end of people's lives with cirrhosis and yet that's not a deterrent for him. Yes, he has a problem.

[Mike]

As of 2012, about 7.2% of individuals in the US have a Alcohol Use Disorder (AUD). That means 92.8% of the population do not abuse alcohol.

In other words, the vast majority of folks can have an occasional drink and leave it at that.

It is true that 7.2% have difficulties with alcohol consumption and should abstain.

However, to compare the AUD population and the associative life experience and health concerns with the rest of the drinking population, is like, well, comparing water to whiskey.

Absolutely no correlation or conclusions can be drawn.

The same is true with an occasional drink and HCV.

Best wishes, Mike

[MrMcSwifty]

Typically, I find that most people who think about alcohol, or "only have 2 glasses a day" have a problem. 

You'll have no argument from me there.  A two drink a day habit absolutely is a problematic amount of drinking, HCV or not.  In fact, I stated precisely that in my very first post.  The thing is, having the occasional drink is not the same as a two-a-day habit, no matter how many times some folks want to insist that it is, and the fact that some insurers are just as unable to make that distinction is disconcerting to me. 

That is why I decided to share my own thoughts and experiences on this subject.  Because I don't think it's the sort of thing that should be treated as a black or white issue.  Alcohol use is not alcohol abuse (and is not alcoholism) and they do not all inflict equal measures of damage to your liver.

And @ donk, you're welcome to believe whatever you want.  I won't even blame you for thinking that.  Just know that I took part in this discussion knowing full well that my opinion wasn't going to be well-received and most likely outright dismissed, so if I am looking for "enablers," I certainly didn't expect to find any here.

[Lynn K]

Hey Mr

We all only wish the best for each other and we all live our lives. In my situation alcohol is not an option forever more.

We plays da game and we takes our chances. I hope you never regret yours however your situation turns out.

For me I may have accelerated developing cirrhosis by my occasional beer or 2 here and there or maybe not who knows.

Wishing you all the best in life and health.

[Tiger]

MrMcSwifty,

If you're not big on "Karma" because your're the numbers guy - I sure give up 
BTW, I have a degree in math and, you know, I am big on Karma specifically because I am the "numbers guy"... Well, still couple of things though:

First, honestly, I am envious of your easy-go-lucky attitude, approach and perspective (which is largely characteristic of the age - envious of that too, obviously  ) I must say, I did enjoy having the same attitude, approach and perspective on life for many years and it was definitely fun and I also miss that at times, but it also comes with a hefty price-tag and results in quite a few problems - this C that I'm dealing with for who knows how long now and that brought me on this forum in the first place is just one of those...

Secondly, I agree with Lynn - we all make our own decisions and choices and take our chances, and then some of us come to regret them. I sincerely hope and wish with all my heart that you're not going to be one of those and that in the end - drink or not - you'll defeat this bloody thing and get rid of it without complications and that the fact that you're dealing with the more difficult GT3 will not matter. I am joining Lynn and everybody else in wishing you all the very, very best!

Thirdly, you may be right and I wrong (I do sincerely hope that's the case) and a drink or two during treatment may not be a big deal and not be doing any harm, but even if so I am still going to stay away not only from that one drink but also anything and everything even remotely harmful - even weed, which honestly I prefer a hundred times and also know for a fact that unlike alcohol it has hardly any affect on my liver and is even good for dealing with C symptoms. Because I appreciate the good fortune of getting this cutting edge treatment, it is my choice to do everything in my power to help it as much as I can and to not take any chances of disrupting it and interfering with it any way...

BTW, FYI, I was never asked by the insurance company whether I drink or smoke weed. As I matter of fact I had no communication with them at all - I just got a call from the pharmacy telling me that I was approved and that they were going to send me this $38K+ bottle with 28 pills... I don't know about you, but I sure am grateful and respect and appreciate this $1300+ daily pill enough not to mix it with anything that may have even a remote chance of interfering with it... and certainly not with a $3 beer...

Wishing you all strong health and enlightened state of mind!

[donk]

OK so 7.2% of the us population has a drinking problem and should abstain. That is about 22 mil out of a US population of about 319 mil but that is flawed because people below drinking age don't drink (15 years old for me). https://ncadd.org/learn-about-alcohol/faqsfacts says 17.6 million which doesn't seem as small as 7.2%.

[Roger]

OK so 7.2% of the us population has a drinking problem and should abstain. That is about 22 mil out of a US population of about 319 mil.

Frankly, I think those numbers are flawed. People lie about their drinking all the time, be it actual lies or forgetfulness.  I have a GP who does not think that 2 glasses a day is a big deal. I have an oncologist who understands that one glass leads to another...

Oh??? and how big is that glass? Nobody knows how big their glass is (remember the daily water intake conversation here?)... and people want to believe that they don't have a problem.

I was in marketing & merchandising (to REALLY big stores) for years.  Ever look at the size of beer & wine departments in the average large grocery store? Ever notice the hundreds of different labels?  My guess is - that retailers do not give up all that square footage for a little 7% slice of the general public. I'm just saying...

Oh!... and we are only talking about the USA here.  Consider the drinking habits in western Europe if you want a jolt on reality.

Anybody can drink what they want, mix it with your medication(s) or not... but really, the bottom line for me is that the stuff is poison - that has been romanced by Madison Avenue to make us believe how wonderful it is.  They did the same thing with cigarettes.  Every single 'prime time' TV show was inundated with cigarette ad's for years, and years. and we all know well that turned out,

[Bituman]

I drank alcohol, occasionally heavily for 32 out of the 40 years I had this disease.  The day I found out I had Hep C, I stopped.  Not one drink in the last 8 years.  I remain amazed that my liver is still in good condition.  Once my wife asked my doctor if I could have an occasional drink and he advised "no, not even one."  I think he knows that one leads to two, leads to four, and so on. 

I often wondered whether I would begin drinking again if I became virus free.  I finally came to the conclusion that I would not, even though inexplicably my liver remains in good shape and probably would not be harmed by an occasional drink.  There are several reasons why.   First, I already have had a lot to drink in my life and don't really need any more.  Second, it feels good to be the only nondrinker in social situations.  It makes me feel unique.  Third, I never have to worry about DUI.  Fourth, I feel better, no hangovers.  Fifth, no useless calories and thus, I can maintain a healthy weight more easily.  I readily admit, however,  that I could eat healthier.  Sixth, it makes me FASTER.  Occasionally I enter a bike race.  In the old days before my arthritic knee I even ran and raced.  I've never been much more than a midpack finisher at best.  But racing challenges me mentally and physically and establishes fitness goals.  Drinking alcohol makes my legs seem heavy. I like hammering up a hill and passing people and that's harder to do with heavy legs.  Maybe some of these reasons resonate with you.

For those who want to have an occasional drink post treatment, I think that's fine.  Assuming your liver remains in moderately good condition I honestly doubt it will hurt you.  But for the above reasons, it's just not for me any more. 

Bob

[beflat10r]

I've known people that went out ( of recovery ) and drank/drugged again after receiving new livers!!!??

[Picnic]

Bituman,
What a great post!! You should be a spokesman!

[MrMcSwifty]

Frankly, I think those numbers are flawed.

I actually agree, but for a different reason.  I can believe that only 7.2% of the population suffers from true alcoholism, however, there isn't a doubt in my mind that there is a much, much larger segment of society that abuses it.  It cannot be stressed enough that there is a difference between alcoholism (actual physical dependency) and alcohol abuse (drinking more than you should), and I don't believe someone who abuses it necessarily falls under the AUD category. 

Then again that's another thing I'm willing to admit I could be wrong about.   

[Tpropane]

How many livers did David Crosby get? Anyway it is all semantics. Alcoholism vs. alcohol abuser. My definition is "An Alcoholic is someone who drinks more than they want to."
And in the case for Hep C or any other liver disease that amount is ONE DRINK.
Because no one with disease ,who wants to live and get better, wants to drink. Whether they can or will stop, that is up to them and their own priorities I suppose. I for one have no intention of dying a horrible death from liver failure and that's that.
TPropane

[Roger]

I can believe that only 7.2% of the population suffers from true alcoholism, however, there isn't a doubt in my mind that there is a much, much larger segment of society that abuses it.  It cannot be stressed enough that there is a difference between alcoholism (actual physical dependency) and alcohol abuse (drinking more than you should), and I don't believe someone who abuses it necessarily falls under the AUD category. 

Abuse vs "true" alcoholism vs a disease... It's all semantics... and a mind set.  Take those drinks away from an alcohol abuser (not a "true" alcoholic) and see what you've got in a few days. My guess is - total chaos.

The long and the short of it is - 'who needs alcohol, more than they need a healthy liver'?  If one wants a healthy liver, one must take care of 'the temple'.  Alcohol will not, cannot, and does not take care of 'the temple'.  Never has. Yep - people like to enjoy the escape (on various levels)... and those who do not take care of 'the temple' will ultimately face the ultimate escape quicker than they might have without the alcohol. (ever see someone die of cirrhosis?)

'Live life' or 'get high'?  Simple question.  And next is 'quality of life' vs 'get high'.  I'm with Bituman on the quality of life without the drink...  Frankly, there is soooo much more to this life than "alcohol".  And think about the quality of 'end of life'.

Drinking screws up the present quality of life big time, and it makes people stupid.  Look in any 'after work bar'... lots of stupid people, talking stupid & doing stupid things.  How bartenders and cocktail waitresses deal with all that stupid is way beyond me!

And look at the last years of life (of an alcoholic) which are worse than you can imagine... and the last years of a cirrhotic life are unthinkable.  If you have never seen anybody die of cirrhosis and liver failure, you are lucky.  Need to get the drink out of your thought patterns?... go to a hospital and visit someone suffering from cirrhosis. It will make that lovely drink taste pretty nasty, that's for sure!

Long and the short of it is "you" have to make choices in life, and age plays a large percentage of those choices, who you hang with, and so on. 

Life & health - or a few laughs, a lot of hangovers, having 'stupid' on your resume, or worse.  No need to hide behind "only 2 drinks a night" - stupid is stupid.  It's our choice.  Harvoni has given us a second chance.  In the words of a famous (and I mean famous) mentor of mine..... "Don't screw it up!"

[Karen1124]

Hi Rodger,
 I'm 57 years old. in April 2014 I found out I have high liver enzymes so they took a hepatitis C test and Here I am. My husband and I drank probably 4 nights a week. we have a Harley so we rode every Sunday we called it Sunday Funday but needless to say I quit drinking when I found out my liver enzymes are high and since then I've been the designated driver except for on the Harley.lol I also had a biopsy of my liver and I have cirrhosis level 3 so at first I thought well I'll drink on special occasions but the more you're around drunk people and you're sober it's not very attractive!! Some people I can't even stand to be around them when I'm not drinking! if I didn't  have any liver damage I might drink more often but at this point I'm thinking it isn't worth it and obviously I acted like a fool too while drinking, looking at it through sober eyes changes you lot. You know that song you're no fun since I quit drinking well I feel that way and probably my friends do too! Life is Good!  I can live without the alcohol!!.....Karen

[MrMcSwifty]

Abuse vs "true" alcoholism vs a disease... It's all semantics... and a mind set.  Take those drinks away from an alcohol abuser (not a "true" alcoholic) and see what you've got in a few days. My guess is - total chaos.

Roger, these things have actual, clinical definitions, and what you keep describing is more than simple alcohol abuse.  If a person can't go more than a few days without a drink... then that is true alcoholism.  It's a physical dependence, which is something that not every person who "drinks too much" will necessarily progress to.  We can go back and forth about the legitimacy of these distinctions all day, but that's probably a discussion for another thread, or a different support group altogether.  One thing I think we are in agreement about is that many people are capable of some impressive mental gymnastics to convince themselves they don't have a problem, but why do you seem so insistent that this describes everyone who enjoys a drink? 

Even if you want to disregard the facts in favor of your own personal anecdotes, I've given you my own example as evidence to the contrary.  I've gone many days and weeks and months without having a drop, never experienced any withdrawals, I don't obsess or think about drinking constantly (as you mentioned before), and my life has not descended into "chaos."  Once in a while I feel like having a beer, so I have one, and that's it.  Yet,  because this means my number of drinks over the past year has been anywhere above ZERO, according to some of you this is proof that I have a "problem."  That's a pretty extreme point of view that I've frankly never encountered anywhere else, not even from my own doctors.

As for the whole quality of life versus health angle, there are plenty of things we all do for enjoyment in our daily lives that negatively impact our health.  Some worse than others.  Drinking coffee raises blood pressure, red meat causes heart disease, etc etc... but does a persons' refusal to give up their morning coffee or steak dinners for the rest of their lives mean they have a problem with caffeine and beef?  Truth be told I had a much easier time giving up my nightly beer than I could my daily coffee!  (you'll have to come pry that coffee out of my cold, cranky, lethargic hands )

Alcohol is undoubtedly at the top of that list when it comes to HCV sufferers, and if you don't enjoy the drink or have simply made a conscious decision not to, then that's great!  Yes, you'll be much better off for it.  It's pretty obvious from reading your posts that you would find no enjoyment whatsoever from a drink these days, regardless of your HCV status, but millions of other people do, and that alone does not automatically mean they are crazy, stupid, or destined for liver failure and death.  Heck, none of us are going to live forever anyways, and even if we could, what's the point if you can't even enjoy the simplest of pleasures? 

"Life & health - or a few laughs, a lot of hangovers, having 'stupid' on your resume..."  These don't necessarily have to be mutually exclusive things. 

[Tiger]

I must say, I agree with a lot of what MrMcSwifty is saying in this last post...
What I do not agree with him is that he thinks OK to have a drink while on HCV treatment...

There's no one definition or pattern in alcoholism or abuse...

I had a real alcoholic friend that drank vodka all day every day, without ever getting to the point of being visibly drunk - I say "had" because he died of cirrhosis.

I also still have one other alcoholic college friend who may not drink for a few months, but then will have one drink, which would lead to many more immediately until he gets totally wasted and then he would just stay in bed drinking for a week, maybe 10 days, until his body no longer accepts alcohol and he switches to tranquilizers and sleeping pills and eventually gets back to senses in couple of weeks and then doesn't drink for another few months until he repeats......

But these are all extreme cases, while most people I know do drink as they want and enjoy it and can handle it without any problems, not to mention a dependency, which BTW in my experience can also be temporary.

I honestly believe that I belong to that "normal" majority, even though I've had all sorts of personal experiences:
I've had drinking sprees that lasted couple of months of heavy drinking (like hangover every day, when you wake up with shaking hands and have to have a drink before doing anything else), but than you get over it and it's gone and you get back to normal life and you can occasionally drink and that won't get you back into that spree.
I also had extended periods when I would naturally hardly drink at all - maybe couple drinks a month. I also had extended periods when I drank almost every day but moderately, without hangover next day/
But then even moderate drinking became increasingly unpleasant since I would get a hangover from just couple of glasses of wine and then I found out that I had C, which explained why that started happening. I didn't completely stop drinking immediately after that, but did reduce intake and in the last few years I hardly drank at all - and I didn't have to make a particularly willful effort, it just happened naturally...

Bottom line, have I abused alcohol? You bet! Did I have a dependency? Yes, at times? Did that dependency last and/or do I have it now? absolutely not! Will I have a drink again once my C is gone (keeping fingers crossed), probably, even likely on special occasions! Will I ever drink to the point of a hangover the next day? Maybe, but probably not.

Again, I consider myself normal in terms of handling alcohol. But those who can't handle it and/or can't control themselves and/or have liver damage, should not drink at all.

I have some Russian friends who shared with me couple of Russian "wisdoms" about  alcohol (alcoholism is Russian national disease):
- what is the difference between a drunkard and an alcoholic?
- a drunkard drinks when he wants to and doesn't drink when he doesn't want to... alcoholic on the other hand drinks when he wants to and still drinks when he doesn't want to...

Another Russian saying is that: those who do not smoke and do not drink will die healthy.

And finally : 

[donk]

You can now fix HepC and to some extent liver health but you can't fix stupid.

[coloradogirl]

Hi Maddawg46,
My doctor said that sugar is metabolized exactly like alcohol and told me I could only have 20 grams of sugar per day! So that is why the decision should be the doctor's decision and the patientand I really just don't have any faith in these boards that are making decisions instead of doctors I really just don't have any faith in these boards that are making decisions and over ruling a doctors decision....... Karen  Life is Good!!

Karen,
You certainly have a good point about sugar. It could even stand as a topic of it's own.  Since I have a sweet tooth, I thought I better find out why. Here is an article about it on this site!
http://www.hepatitiscentral.com/news/the_not-so-swee/

And thank you Karen, for bringing it to our attention!

[Karen1124]

Hi Colorado girl,
That was very interesting link on sugar thank you for sharing. I am not a person who likes sugary foods. But I do like white bread and potato chips. The reason I mentioned it in the alcohol thread is because I think people don't realize what they're eating also causes inflammation in the liver. I hope everyone visit this site will click on that link in read how sugar effects the liver!

Thank you.........Karen. Life is Good!!

[koifish54]

About sugar and carbs if I have alot of sugar I feel like crap sorta like a hangover very interesting karen thanks

[Karen1124]

Hi Koifish,
My doctor told me 20 grams of sugar a day in July and in two weeks I did tell such a difference!! he said that sugar actually causes inflammation in the liver! he said its metabolized in your body just like alcohol! I hope that you start feeling better have a great day! Life is Good! Karen

[Karen1124]

Karen,
You certainly have a good point about sugar. It could even stand as a topic of it's own.  Since I have a sweet tooth, I thought I better find out why. Here is an article about it on this site!
http://www.hepatitiscentral.com/news/the_not-so-swee/

And thank you Karen, for bringing it to our attention!

[coloradogirl]

So for perspective 20 mgs of sugar = 5 teaspoons of white and brown sugar.

That's not much at all! But when I look back at my excess sugar consumption (eating the rest of the cookies, or drinking a few sugary drinks) it does correspond to my joints aching the next day. And I thought is was because of the weather! ha ha!

[MEG]

Thanks all for this conversation on glucose. It refreshed my memory and gave me inspiration to keep my no sugar/white food policy while on the H...I'd already dramatically decreased my raw sugar intake over the years. But, I did allow myself occasional indulgences. ;-)

I need sweet in my one mug of decaf. I switched to Xylitol. I don't notice any difference in taste. Unlike with Stevia which is a bit too bitter for me...

[koifish54]

Mike I guess my question is why isn't this study even mentioned or considered anywhere this is the first time seeing this about alcohol or other information says definitely increase s replication of hcv virus  I'm not talking about heavy consumption that's a no brainer

[Mike]

Because, as more research on the topic becomes available, what was thought 10 or 20 years ago, becomes less prevailing.

This is clear when looking at diabetes and HCV. Prevailing wisdom 10 years ago, suggested a direct link between the two. This link, however, has been debunked as more research became available. 

Please note that I'm not proposing that folks with HCV start consuming alcohol. I am, however, suggesting that an occasional drink is not a death knell for your liver if you have HCV.

Best wishes, Mike

[koifish54]

No I am not saying go out and get wasted either but the more knowledge we all have and with our Dr's advice and our livers condition people can make a educated decision  this subject comes with much debate and is not a clear cut answer

[Mike]

Sure there is a clear cut answer: Drinking one or two beers a month causes no more liver damage than can or two of Pepsi.

Mike

[dragonslayer]

Here's what Im wrestling with.  My most recent biopsy was March, 2013 which scored stage 0-1, grade 0-1.  I recently tested at 11 wks post treatment undetected, and consider myself SVR12 as a result (although SVR11 would be more technically correct).. After my dr told me I could go have a beer after the good news,  Ive been slowly allowing myself to join friends in some light drinking a couple of times  a week, usually with dinner, which I fastidiously avoided for > a year prior to my clearing the virus.  So, Im enjoying the occasional beer and wine again, yet my fear is, what about the SVR24 test, and later, SVR48?   What if the virus returns unbeknownst to me and Im fueling its damage by imbibing?  Hopefully, since that SVR24 test is only a couple months away, any damage I might be doing will be minimized by the short duration of its occurance.   I realize that SVR12 is viewed as tantamount to a cure these days, but its hard to truly believe life can once again resume as normal.   There's always this nagging doubt, and the question is, how much voice should we give it?!

[Roger]

Paul,
For me - the best method of understanding is to 'not drink'. 
With Harvoni we have received a new lease on life, so why screw it up?
I still go out with friends - they drink, I don't. No big deal.

Before understanding how close I was to leaving this earth, not drinking with
my friends would have been a VERY big deal.  All this just puts things in
perspective.  Why risk it.  A lot of people with HCV tend to do things like
drinking with gusto. It starts with one little drink.

Who needs it?  If one is concerned about their drinking, then their drinking
just might be a concern!  If it's not a concern, an occasional drink will not
hurt things... but if one drink leads to a new life of drinking, I'd say stop.

My Hepatologist told me that my liver will regenerate itself into a new liver.
Alcohol could stunt that healing process.

Hope this helps!

[DisabledHepcat]

Well, here is the data.
My treatment however was an overkill since I only had 1.2 million IU/ML
with no cirrhosis and received 12 weeks of Harvoni. For some reason since I am on SSDI and Medicare nobody asked for any tests before my 12 week prescription was filled. All I needed was the prescription in which I got 1 week after Harvoni was approved. I did not start treatment until I had all 3 bottles in hand. Started Dec 30th 2014.
After 8 Harvoni pills my Virus went from 1.2 million to 190
I did not have anything to drink until day 33 in which I figured I was undetectable at that point since I went down to 190 after 8 days. I was tested after 36 pills as Not Detected. BTW, all of the beers listed below were 3.2% from the grocery store.
1-32 days no drinking
33 - 9 beers
34 - 16 beers
35 - 5 beers
36 no drinking plus Blood work undetected
37 thru 44 no drinking
45 - 13 beers
46 - 13 beers
47 - 6 beers
48 - 4 beers
49 no drinking
50 - 7 beers
51 - 13 beers
52 - 10 beers
53 - 61  no drinking
62 - 4 beers
63 - 4 beers
64 - 11 beers
65 - 19 beers
66-84 no drinking
I also took my last 10 pills like this
75 after 12 hours
76 after 12 hours
77 after 12 hours
78 after 12 hours
79 after 12 hours
80 after 12 hours
81 after 23 hours
82 after 22 hours
83 after 20 hours
84 after 21 hours
I wanted to take the last 10 pills as a mean gesture to kill off any viruses that were tough enough to still be around.
5 weeks off treatment  Not Detected
Ta Dah
wow, that 19 beer day was long - lol
Call me irresponsible but I am still mentally disabled from the 4 years of Interferon
from 1996-2000 and not as grateful as most people would be. Schizophrenia and severe clinical depression are no fun to live with and now I will live longer. I am going to stop drinking for the next 2 months for some serious liver rebuilding since I have no HCV now. I will continue to bring on the Whey protein which kept me from cirrhosis for the past ? years, massive eating of hamburgers and chicken not to mention Screamin Sicilian frozen pizza's from Kroger.
YUM !  I will get my liver back in shape so I can at least enjoy drinking again in which I started when I was 15 years old up until 33 years old and stopped for a 16 year period up until the past 4 years and than Harvoni came out. I am pretty sure I would be dead if I did not stop for that 16 years but now that I am 55 years old I'm going to enjoy my life the way I want to with drinking. Thanks Gilead !!!

[koifish54]

I guess I should have titled my post alcohol after Harvoni