Association between elevated coffee consumption and daily chocolate intake with normal liver enzymes in HIV-HCV infected individuals: results from the ANRS CO13 HEPAVIH cohort study

Abstract

Background & aims: We used longitudinal data from the ANRS CO13 HEPAVIH cohort study of HIV-HCV co-infected individuals to investigate whether polyphenol rich food intake through coffee and/or daily chocolate consumption could play a role in reducing liver enzymes levels.

Methods: Longitudinal data collection included self-administered questionnaires and medical data (aspartate aminotransferase (AST) and alanine aminotransferase (ALT) liver enzymes). Two analyses were performed to assess the association between coffee (≥3 cups a day) and daily chocolate intake and abnormal values of AST and ALT (AST or ALT >2.5 × upper normal limit (UNL)) (N=990) over time, after adjustment for known correlates. Logistic regression models based on generalized estimating equations were used to take into account the correlations between repeated measures and estimate adjusted odds ratio.

Results: After adjustment, patients reporting elevated coffee consumption and daily chocolate intake were less likely to present abnormal ALT (OR=0.65; p=0.04 and OR=0.57; p=0.04, for coffee and chocolate respectively), while only patients reporting elevated coffee consumption were less likely to have abnormal AST values (p=0.05). Nevertheless, the combined indicator of coffee and chocolate intake was most significantly associated with approximately 40% reduced risk of abnormal liver enzymes (p=0.003 for AST; p=0.002 for ALT).

Conclusions: Elevated coffee consumption and daily chocolate intake appear to be associated with reduced levels of liver enzymes in HIV-HCV co-infected patients. Further experimental and observational research is needed to better understand the role that polyphenol intake or supplementation can play on liver disease and liver injury.

Keywords: ALT; ANRS; ART; AST; AU; AUDIT-C; Agency for Research on Aids and Viral Hepatitis; Alcohol Use Disorders Identification Test; BMI; CD4; CDC; Centers for Disease Control and Prevention; Chocolate; Cocoa; Coffee; GEE; HCV; HIV; Hepatitis C; IDU; IQR; IU/L; Liver enzyme; OR; PegIFN; Polyphenol; RNA; TGF-beta; UNL; alanine aminotransferase; alcohol units; antiretroviral treatment; aspartate aminotransferase; body mass index; cluster of differentiation 4; generalized estimating equations; hepatitis C virus; human immunodeficiency virus; international units/liter; interquartile range; intravenous drug users; kPa; kilopascal; odds ratio; pegylated interferon; ribonucleic acid; transforming growth factor beta; upper normal level.