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Even moderate amounts of alcohol can be dangerous for people with hepatitis C, according to a new study.

The study supports the recommendation that people with hepatitis C should limit the amount of alcohol they drink, according to author Dr. Zobair Younossi of Inova Fairfax Hospital in Falls Church, Virginia.

Hepatitis C researcher Rae Jean Proeschold-Bell of Duke University, who was not involved in the study, told Reuters people with the liver disease have higher alcohol use rates, compared with people without the disease. “What this study shows is… truly, even what might be considered a moderate and safe amount of alcohol use in people without hepatitis C is dangerous to your health if you have hepatitis C,” she said.

Previous research has shown that drinking large amounts of alcohol can worsen liver disease causes by hepatitis C. Researchers have disagreed about whether lower amounts of alcohol would cause similar health effects.

An estimated 3.2 million Americans have a chronic hepatitis C infection, which is spread through blood. Hepatitis C can cause severe liver damage. While in many cases the disease can be treated with medication, in some cases, it requires a liver transplant.

In the new study, researchers compared 8,767 people without hepatitis C, to 218 with the disease. Participants were followed for 13 to 14 years. In that time, 19 percent with hepatitis C, and 11 percent without the disease, died.

People with the disease who had three or more drinks a day were five times more likely to die, compared with people who drank the same amount but did not have hepatitis C. People with the disease who had up to two daily drinks were twice as likely to die during that period, compared with those who drank the same amount but did not have hepatitis C.

The study appears in the journal Alimentary Pharmacology & Therapeutics.

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