The hepatitis C virus (HCV) causes inflammation and damages liver cells. Over the course of decades, this damage accumulates. The combination of excessive alcohol use and infection from HCV can cause significant liver damage. It can lead to permanent scarring of the liver, known as cirrhosis. If you’ve been diagnosed with chronic HCV infection, you should refrain from drinking alcohol.

The liver performs many important functions, including detoxifying the blood and making many important nutrients that the body needs. When you drink alcohol, the liver breaks it down so it can be removed from your body. Drinking too much can damage or kill liver cells.

Inflammation and long-term damage to your liver cells can lead to:

Fatty liver disease and early-stage alcoholic hepatitis can be reversed if you stop drinking. However, damage from severe alcoholic hepatitis and cirrhosis is permanent, and may lead to drastic complications or even death.

Exposure to the blood of someone who has HCV can transmit the virus. According to the Centers for Disease Control and Prevention (CDC), over three million people in the United States have HCV. Most don’t know they’re infected, largely because the initial infection may cause very few symptoms. About 20 percent of people exposed to the virus manage to fight off hepatitis C and clear it from their bodies.

However, some develop a chronic HCV infection. The CDC estimates that 60 to 70 percent of those infected with HCV will develop chronic liver disease. Five to 20 percent of people with HCV will develop cirrhosis.

Studies show that substantial alcohol intake with an HCV infection is a health risk. A 1997 study published in The Lancet showed that alcohol intake of over 50 grams a day (approximately 3.5 drinks per day) leads to an increased risk of fibrosis and ultimate cirrhosis.

Other studies have confirmed that excessive alcohol use increases the risk of cirrhosis. A French study of 6,600 HCV patients concluded that cirrhosis occurred in 35 percent of patients who were heavy drinkers. Cirrhosis occurred in just 18 percent of patients who were not heavy drinkers.

A 2000 JAMA study showed that just three or more daily drinks can increase the risk of cirrhosis and advanced liver disease.

Direct acting antiviral therapy to treat HCV infection can lead to a reduced risk of liver disease. However, alcohol use may interfere with the ability to consistently take the medication. Sometimes, practitioners or insurance companies may be hesitant to provide treatment for HCV if you are still actively drinking.

Overall, evidence shows that alcohol consumption is a big risk for people with HCV infection. Alcohol causes damage that compounds damage to the liver. Even small amounts of alcohol may increase the risk of liver damage and advanced liver disease.

It’s important for those with HCV to take steps to reduce their risk of developing advanced liver disease. Schedule regular checkups, visit the dentist, and take appropriate medications.

Avoiding substances that are toxic to the liver is vital. The collective effects of alcohol on the liver and the inflammation caused by HCV can be serious. Those with an HCV infection should abstain from alcohol completely.