Alcohol and Hepatitis C

Abstract

Alcohol abuse and hepatitis C virus (HCV) infection coexist with chronic liver disease in many patients. The mechanism of injury in these patients is probably multifactorial and involves, but is not limited to, a combination of diminished immune clearance of HCV, oxidative stress, emergence of HCV quasi-species, hepatic steatosis, increased iron stores, and increased rate of hepatocyte apoptosis. In patients with HCV infection, alcohol consumption is known to cause accelerated progression of liver fibrosis, higher frequency of cirrhosis, and increased incidence of hepatocellular carcinoma (HCC). These patients also have decreased survival as compared with patients with either alcohol abuse or HCV liver injury alone. Alcohol abuse causes decreased response to interferon treatment in HCV patients. It is therefore necessary for patients with HCV infection to abstain from alcohol consumption.

Abrogation of the Antifibrotic Effects of Natural Killer Cells/Interferon-γ Contributes to Alcohol Acceleration of Liver Fibrosis

“…[5][6][7][8][9] In rodents, ethanol feeding was also shown to accelerate CCl 4 -induced liver fibrosis. 10 It is generally believed that ethanol feeding enhances CCl 4 metabolism by induction of cytochrome P450 2E1 expression and, subsequently, enhances CCl 4 -induced liver injury.…”

“…[1][2][3] Alcohol consumption, hepatitis C viral (HCV) infection, and nonalcoholic steatohepatitis are currently the 3 main causes of chronic liver injury leading to liver fibrosis. 4 Interestingly, alcohol consumption was shown to accelerate liver fibrosis in patients with chronic HCV infection [5][6][7][8][9] and in animals treated with hepatotoxins. 10 The obvious underlying cause for this is enhanced liver injury induced by alcohol; however, this does not fully explain the acceleration of liver fibrosis observed.…”

Molecular Mechanisms Involved in the Interaction Effects of Alcohol and Hepatitis C Virus in Liver Cirrhosis

“…Reported data suggest that HCV is not directly cytopathic to the hepatocyte, and the main focus of pathology of HCV infection has been on inflammation from the immune response as the main contributor of reactive oxygen species from macrophages and neutrophils (24). Alcohol is considered an accelerant of illness in individuals infected with HCV (25,26). There is a higher rate of HCV infection among alcoholics than the general population and there is a 40% increased risk of morality in alcohol abusers with HCV (27).…”

Worse Outcomes among African Americans with Liver Cancer: What Might Cause the Disparity?

“…Additionally, alcohol has immunologic and oxidativestress related consequences on the livers of patients who are infected with HCV [31]. It's controversial whether diabetes mellitus (DM) increases HCC risk in the absence of other causes of liver disease [30,32,33].…”