Chronic liver disease: Do alcohol and hepatitis C virus interact?

Abstract

In chronic liver disease, alcoholism and hepatitis C virus (HCV) frequently coexist, and it is widely believed that they interact to result in more severe disease. However, the issue is far more complex and that view may be incorrect. Newer HCV assays cast doubt on the earlier results. Data acquired in one country are often at variance with those from other countries, suggesting that other factors may be involved in the variability of the disease. Further comparison of histologically different groups of individuals with excess alcohol intake is unlikely to shed further light on the issue unless information on the duration and quantity of alcohol consumption and the duration of HCV infection is available. The net evidence is that HCV and alcohol produce different histological appearances in the precirrhosis stage with the end result cirrhosis often being indistinguishable, regardless of aetiology. Nevertheless, even with both aetiologies, progression is slow and only a minority of people develop cirrhosis despite the combination of HCV and heavy alcoholism. As yet there is no definite evidence that cirrhosis develops more frequently or sooner if both HCV and alcohol are present . Although the majority of the evidence suggests that these insults are probably additive, there is a possibility that alcohol and HCV do interact in the pathogenesis of chronic liver disease. Further studies will be necessary, however, to clarify their relationship.

Role of alcohol in the progression of liver disease caused by hepatitis C virus infection

“…While other investigators have also found an association between alcohol intake and the presence of cirrhosis, these findings have not been universal, and the relationship between alcohol and HCV in the progression of liver disease requires clarification. 28 A recently published study of 2,235 HCV-infected patients found daily alcohol consumption of 50 g or more to be an independent risk factor for the progression of fibrosis. 17 Similar conclusions have been reached by earlier studies that examined much smaller and select population samples.…”

“…28 A recently published study of 2,235 HCV-infected patients found daily alcohol consumption of 50 g or more to be an independent risk factor for the progression of fibrosis. 17 Similar conclusions have been reached by earlier studies that examined much smaller and select population samples.…”

Risk factors analysis for hepatocellular carcinoma in patients with and without cirrhosis: A case–control study of 213 hepatocellular carcinoma patients from India

“…Positive interaction between HBV infection and alcohol intake as a cause of liver injury has been controversial 10,11 . Also the synergism between HCV infection and alcohol drinking requires further research 12 …”

Hepatitis C and Alcohol

“…Soon after the introduction of serological tests for an antibody to HCV (anti-HCV), it became apparent that hepatitis C is common among alcoholics with liver disease and that the two etiologies may interact to result in a more severe disease. The interaction of alcohol and HCV has been studied extensively, and the available data has been reviewed by several authors (Cooksley 1996;Grellier and Dusheiko 1997 ;Marsano and Pena 1998;Naplas et al, 1998;Schiff 1997). This review summarizes the literature of the last ten years on this subject.…”