I’m curious how other people with HBV handle their vices - no alcohol ever? sometimes? and cigarettes - and since it’s legal in plenty of places marijuana?
and for those with scientific knowledge - would using weed/alcohol or whatever if you’re on medication (vemlidy, entecavir etc) increase the risk of drug resistance? or be bad in any other way?
Dear @joseph,
Great questions. I don’t smoke and it’s pretty bad for your health (including liver health) with little benefit. It was easy for me not to have this habit as smokes are super expensive here in Australia.
Marijuana here in Australia is illegal in most states, but I would guess edibles are probably a better way to go than smoking, just for the benefit to your lungs. As has been discussed before, there’s no good evidence for or against marijuana being harmful.
Regarding alcohol, I’ll repost a message I posted on HBList a while ago
According to the clinical literature I’ve seen, the cancer risk of HBV and alcohol has generally been reported as an “additive” relationship (e.g. if the risk of HBV cancer is 20% and the alcohol consumption is 5%, then the combination is 25%) rather than a “synergistic” relationship (20%+5% = something more than 25%) in most cases. In the end, it is up to you to decide if you want to take this risk or not.
That said, it’s probably best to reduce it as much as you can, even if you don’t have Hep B. There are plenty of ways around reducing your drinking at social events (which I have personally generally reduced a lot):
- As Olga mentioned, making a socially-acceptable excuse for not drinking
- Drinking non-alcoholic drinks that look like alcoholic drinks (there’s now a bit more choice in terms of low alcoholic beers and wines, some of which actually taste good!)
- Standing up and owning it by saying I just don’t feel like drinking
- Drink slower and space out the drinks with glasses of water in between
- Eating before to slow down alcohol absorption
Obviously, some options may not be available to you in all circumstances, but these may help. I’ve also realised that a lot of the effects of alcohol are from the interactions with the people around you rather than from the alcohol itself. I think if you start drinking a good non-alcoholic beer/wine (where you can’t tell much difference between it and the real version), you may be surprised about how similar it can feel to drinking alcohol (minus the hang-over).
Few studies have shown any of these having an effect on Hep B drug resistance at all.
Hope this helps,
Thomas
Thanks for your time Thomas 
With weed, I don’t know if your liver is infected. With my job, since marijuana is only legal in certain states, and illegal on the federal level, it’s a huge no no.
I stop drinking, even though I drank a lot last year or enough for any hep b patient. It could give you hgher alt or ast level and could put you on meds when on monitoring stage. But it’s just a guess.
I smoke a cigar from time to time. Maybe 0-3 a month. Also, eating sugar can be as damaging
Does anyone know anything about the usage of cannabis with chronic hep B. I am 23 years old and workout daily. Sometimes when my body is sore I use cannabis in moderation, I have heard many different opinions. When tested ALT and AST were normal while using cannabis.
it seems like the best answer is - nobody really knows for sure lol so no…sorry I can’t help much - but my non- scientific guess is that moderation is probably not going to have any effect one way or another -
they have had studies where weed actually helps - but also had studies where it worsened disease but if I’m not mistaken that was with Hep C and also related to daily usage. - so yeah, we don’t know
What is the moderate amount of alcohol that can be considered ok to drink,how much of beer can be taken in week or month that should not have big effect on hep b. If I take alcohol or beer what could be the best to help me detox the next day. I know it’s best to avoid alcohol and any cost,I have been making so many excuses not to drink while I hang out with my drink mates but sometimes it’s very hard giving them so many excuses to avoid drinks. since I couldn’t tell them I have hep b because of the stigma coming.
Please advice me on this.
Hi @12345678,
While it’s probably best to restrict your alcohol consumption as much as possible, the recommended limits for people without Hep B is as follows (from https://www.hepb.org/blog/fun-fireworks-and-alcohol-consumption-over-the-holiday-weekend/):
For healthy women who do not have hep B, 20 grams of alcohol, per day and for men without HBV, 60 grams of alcohol per day is risky business and may very well contribute to liver disease. This equates to 60 ml. of sixty-proof liquor, or 200 ml. of wine (12% alcohol), and 500 ml of beer (5% alcohol).
This doesn’t “build-up”: you shouldn’t abstain for 6 days so that you can have 3L of beer on a Friday night.
TT
Dear all,
Happy new year’s eve all of you celebrating. I thought it might be good to share this nice article for tips to have an alcohol-free night tonight: Tips for enjoying an alcohol-free New Year's Eve celebration as more Australians go sober - ABC News
See you next year!
Thomas
Happy New Year to all of you! Thank you Thomas for another year of dedication. Thanks to all the experts for your time and effort. Thanks to each of you that contribute and make this community a better place.
-Paul
Happy new year…
Thanks to Thomas and Andrew/availlant and their contribution…
Hope a better year is ahead of us!! Thanks
Just wondering how bad an occasional drink or 2 is like every couple months? Or only a couple times a year say for a wedding or special occasion?
Hi @PkR,
Great question. A glass of wine or a bottle of beer occasionally or socially is okay. Severe alcoholism is what is bad. I hope this is helpful. Bansah1
I’ve just moved this question to a more appropriate existing thread. Please see above for the responses on this topic.
Thomas
What if occasions happens everyday ? 
I smoke cigars sometimes. I smoked 1-2 a week to none for couple months. Anyways that is my vice. I don’t smoke weed or drink. I am going to our annual vacation with my family and my brother’s family. Probably drink alcohol there but maybe for a day.
Probably not the best, and no one on the vacation are drinkers, but I m just going to drink couple drinks.
As a chronic carrier from birth, I don’t drink much. Maybe 1-2 drinks a month at the most, but also go many months at a time without any alcohol. My doctor said since all of my tests monitoring my liver and function have historically come back normal a drink here and there won’t hurt. Does any one have other opinions on this? Obviously no alcohol is the best option but I’m young and sometimes want one on a special occasion. Can one or two drinks here and there directly cause immediate liver damage
Hi @kostas,
I do agree with your doctor and your point as well. If you can abstain completely that is great, but if you can’t plan on drinking occasionally that should be fine as well. The damage is done through frequent drinking, and not occasionally. You should be fine with one drink a month or 2, as long as you do not abuse it. I hope this is helpful, Bansah1.
I agree with Bansah1. I have never stopped completely, but I am trying to limit to a drink or two in a week. I have never had any issues for 25-30 years. But, it’s definitely better to stay away from alcohol completely, especially for us HepB carriers.
Hi @kostas, I’ve integrated your post to this thread as there are relevant answers here.
Cheers.