Effect of alcohol consumption on serum hepatitis C virus RNA and histological lesions in chronic hepatitis C

Abstract

The role of alcohol intake in the occurrence of severe liver disease in chronic hepatitis C virus (HCV) carriers is still debated. A cross-sectional study has been conducted in 233 chronic hepatitis C virus carriers. Weekly self-reported alcohol consumption (SRAC) was evaluated, serum HCV RNA levels were measured by a branched DNA technique (Quantiplex 2.0) and HCV genotypes were determined. A liver biopsy was performed simultaneously and liver lesions were graded with the Knodell histological activity index. Data were examined by uni-and multivariate analyses. Alcohol consumption was relatively low (F 140 g/per week in 193/233 patients [80%]). We found a highly significant correlation between SRAC and serum HCV RNA levels (r ‫؍‬ .26, P ‫؍‬ .001). Fibrosis was significantly correlated with age and alcohol consumption. These results suggest that in HCV carriers, alcohol consumption, even with low alcohol intake, increases viremia and hepatic fibrosis. Chronic HCV carriers should be advised to avoid regular alcohol intake. (HEPATOLOGY 1998;27:1717-1722.)The natural course of HCV infection is probably modulated by several cofactors. The role of virus-related factors, namely genotypes and viremia has been extensively studied 1-7 but still remains debated. 8 Up to now, immunological factors were underestimated but several arguments implicate the role of immune response in the course of the disease. Environmental factors and particularly alcohol intake are probably major factors, 9-10 and the increased severity of the disease and the faster occurrence of cirrhosis in patients with HCV infection and heavy alcohol intake has been suggested in several studies. [11][12] Moreover relations between alcohol and the immune response have been suggested with other viral infections. 13 The aim of the present study is to describe the effect of moderate alcohol intake on serum HCV RNA levels and histological liver lesions in patients with chronic HCV infection.

Influence of Cannabis Use on Severity of Hepatitis C Disease

“…The strong recommendation for HCV-infected persons to limit or abstain from alcohol use (18,19) reflects the consistent association between heavy alcohol use and more severe fibrosis and greater risk of cirrhosis (2,(20)(21)(22). Similarly, steatosis has recently been identified as an important factor associated with fibrosis severity (23).…”

The impact of illicit drug use and harmful drinking on quality of life among injection drug users at high risk for hepatitis C infection

“…The physical health benefits of alcohol reduction, particularly for those infected with hepatitis C, are well-established. Research has shown that relatively low amounts of alcohol use (70 grams to 139 grams alcohol/week) in hepatitis C patients have been associated with significantly increased serum HCV RNA levels and increased histological activity (Pessione et al, 1998). In addition, the strong independent association of alcohol use and reduced HRQL in this analysis raises the possibility that reducing alcohol use could be marketed to out-of-treatment at-risk populations as a behavior that is likely to improve not only their physical health but also their quality of life with respect to feelings of well-being, and daily social and physical functioning.…”

Tumor necrosis factor gene polymorphisms in patients with cirrhosis from chronic hepatitis C virus infection

“…Alcohol use alone has been shown to contribute to the progression of fibrosis in HCV infection. [7][8][9] Our lack of a detectable independent deleterious effect may deserve further investigation based on an increased sample size, especially as controlling the effects of factors such as viral genotypes, alcohol consumption, patient gender and duration of infection through multivariate modeling produced genetic associations with slightly increased strength (Table 4; model II). Patient gender, viral genotypes and the duration of infection are not significant independent contributors to cirrhotic outcome compared to the host genetic factors examined.…”