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

Authors

  • George Ostapowicz,

    1. Department of Gastroenterology, St. Vincent's Hospital Australia
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    • Ostapowicz was supported by a Postgraduate Medical Research Scholarship from the Gastroenterological Society of Australia

  • Katrina J. Watson,

    1. Department of Gastroenterology, St. Vincent's Hospital Australia
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  • Stephen A. Locarnini,

    1. Victorian Infectious Diseases Reference Laboratory, Melbourne, Victoria, Australia
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  • Paul V. Desmond

    Corresponding author
    1. Department of Gastroenterology, St. Vincent's Hospital Australia
    • Department of Gastroenterology, St. Vincent's Hospital, 41 Victoria Parade, Fitzroy, Victoria, 3065, Australia. Fax: 613-9288-3590
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Abstract

In patients with chronic hepatitis C, alcohol consumption has been proposed as a risk factor for the progression of liver disease; however, evidence for this remains conflicting. Two hundred thirty-four anti–hepatitis C virus (HCV)–positive patients who had a liver biopsy performed within the past 24 months were studied. Demographic data and information on risk factors were recorded. A detailed lifetime alcohol consumption history was obtained. Viral studies included HCV viral titer and HCV genotype. Mean age (± SEM) of the group was 40.8 ± 0.7 years. One hundred sixty-six (71%) were male. A risk factor for HCV infection was found in 195 patients (86%). Genotype distribution was: 1b: 22%; 1a: 15%; 1(nonsubtypable): 15%; 3a: 34%; and 2: 7%. Fifty (21%) patients had cirrhosis. Patients with cirrhosis were older (51.6 ± 1.8 years) than those with chronic hepatitis (37.6 ± 0.6 years; P = .0001), were infected at an older age (25.9 ± 2.0 vs. 20.9 ± 0.6 years; P = .001), and had a longer duration of infection (20.5 ± 1.3 vs. 16.2 ± 0.5 years; P = .0008). Patients with cirrhosis had a greater total lifetime alcohol consumption (288,765 ± 58,115 g) than those with chronic hepatitis (189,941 ± 15,453 g; P = .018). Cirrhotic patients also had greater total alcohol consumption during the period of infection with HCV (240,962 ± 63,756 g vs. 146,510 ± 12,862 g; P = .02). On multivariate analysis, subject age and total alcohol consumption were independently associated with the presence of cirrhosis. Total lifetime alcohol consumption is a risk factor for the progression of liver disease caused by HCV.

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